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Geriatrics > 2. Aging > Flashcards

2. Aging Flashcards

1
Q

Define aging

A

cells tissues and organs may vary in age related change in the same person but are ultimately connected

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2
Q

Life span when expressed as expectancy from 65 (has/hasn’t) changed very much

A

hasn’t

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3
Q

Mortality is commonly caused by

A

some disease or disease process (bodies ability to withstand these diseases at

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4
Q

Lifespan is expressed as

A

life expectancy from birth or a latter age

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5
Q

T/F Max life-span has changed little

A

t

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6
Q

Currently the maximum verifiable lifespan is how old

A

122

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7
Q

Max lifespan reaches an asymptote at what age

A

115

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8
Q

Prove that there is a genetic link to lifespan

A
  • Hybrid vigor (increased longevity in hybrids)
  • Parental age (parents live long you will likely as well)
  • Twin studies (less of a difference in lifespan between monozygotic compared to dizygotic twins)
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9
Q

Werner’s syndrome is what type of disease

A

premature aging syndrome

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10
Q

Inheritance pattern of Werner’s syndrom

A

autosomal recessive

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11
Q

Characteristics of Werner’s syndrome

A
  • Growth retardation during teens
  • Short
  • Premature graying and hair loss
  • Thin skin
  • Osteoporosis
  • Atherosclerosis
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12
Q

Functions that predictably decline with age related to the oral cavity

A
  • Swallowing
  • Tongue function
  • Taste acuity for salt, bitter and umami
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13
Q

Other functions that predictably decline with age are

A
  • Vital capacity
  • Cardiac output
  • Renal plasma flow
  • Glomerular filtration rate
  • Grip strength
  • Reaction time
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14
Q

Functions that don’t change with aging are

A
  • pH and electrolyte content in blood

- Verbal intelligence (unless dementia)

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15
Q

The rate of yearly loss seems to be -% of the functional capacity present at age 30

A

0.8-0.9%

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16
Q

Mortality doubles every _ (time) after age 30

A

7 yrs

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17
Q

A risk factor for most diseases is

A

aging

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18
Q

What is the Hayflick limit

A

a principle related to dividing cells stating that the mother cell can only produce so many daughter cells until there is a cap

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19
Q

When cell in the human body has a hayflick limit that is related to age

A

fibroblasts (have an average of 50 population doublings before a sharp decline in proliferation)

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20
Q

Describe the telomere theory

A

-Everytime a cell replicates a part of the telomere on the end of DNA is lost and one it is gone replication can no longer occur due to cell damage

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21
Q

What cells are exempt from the telomere theory and why

A

cancer cells and germ cells because there is a telomerase enzyme

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22
Q

When telomerase is active the telomers are (degraded/maintained)

A

maintained (just like the vitality of the cells)

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23
Q

Describe the free radical theory

A

-As a cell ages the number of free radicals increase which cause damage to cell membranes and create cellular waste which accumulates

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24
Q

Describe the cell membrane theory

A

As a cell ages the membrane becomes less lipid and less watery (more solid)

  • Cell loses ability to transfer chemicals, electrical charge
  • Toxic accumulation of lipofuscin which we se in brain, heart, lung and skin
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25
Q

Explain the mitochondrial decline theory

A
  • ATP can’t be stored in the body
  • Organs and cells can’t transfer ATP from each other
  • As free radical damage occurs to mitochondria they produce less ATP
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26
Q

Describe the glycosylation theory

A
  • AKA cross linking theory
  • Binding of sugar to protein occurs in presence of oxygen (a potent free radical)
  • Causes cell to loose elasticity due to glycosylation which increases stiffness in skin, BVs, etc.
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27
Q

Describe cross-linking theory

A
  • Postulates that aging causes by molecules becoming irreversibly immobilized by cross- linking
  • Cross-linking of collagen which makes up 25% of bodies protein
  • Cross-linking theorized to affect the flow of nutrients and waste products from cells
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28
Q

Describe the neuroendocrine theory

A
  • Hypothalamus is damaged over time by cortisol secreted by the adrenal gland
  • Cortisol is linked to stress and is one of the few hormones which increases with age
  • Receptors that uptake various hormones lose their sensitivity
  • Cascade effect leads to multiple diseases seen in later age
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29
Q

Calorie restriction can (increase/decrease) aging process

A

decrease (mechanism= unknown)

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30
Q

Describe the evolution theory

A

organisms only needed to survive long enough to reproduce and care for their offspring (before medical advances)

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31
Q

The biologic clock theory is dictated by what two events

A
  • Puberty

- Menopause

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32
Q

SIR2 gene is present in (few/some/many/all) organisms

A

all

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33
Q

SIR gene encodes _ proteins which are found where

A

sirtuins found in red wine

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34
Q

The presence of sirtuins found in red wine is significant why

A

because the french live longer and their diet is rich in high fat and red wine

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35
Q

Rapamycin is what kind of drug

A

antifungal agent - also can be used to suppress immune system in transplant patients

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36
Q

Rapamycin influences the ways cells respond to what

A

insulin and IGF

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37
Q

What is IGF

A

insulin growth factor

38
Q

Rapamycin increases or decreases life span

A

increases (goes back to calorie restriction

39
Q

IGF (promotes/inhibits) cell dividion and growth

40
Q

When food is plentiful insulin and IGF (increase/decrease)

41
Q

FOXO gene is involved in

A

regulating the insulin/IGF pathway

42
Q

Mutations in FOXO gene has lead to (increased/decreased) life span

43
Q

More diseases in older people, what is causing the killing the diseases or the age

A

the age because the same diseases in younger people typically aren’t lethal (i.e pneumonia)

44
Q

What disease causes the most death in older people

A

heart disease

45
Q

Skin changes related to aging: what skin ages most rapidly and why

A

face and hands due to exposure

46
Q

Skin thickness (increases/decreases) after 60

47
Q

Look at slide 42 for histologic changes in skin

A

ok

-atrophy, fewer fibroblasts, fewer BVs, etc.

48
Q

Dental issues associated with skin changes in elderly

A
  • Acintic elastosis
  • AKA senile elastosis or solar elastosis

Skin is wrinkled dry and atrophic and flaccid
Vermillion border of lip not sharp
May be premalignant

49
Q

During aging muscle mass (increases/decreases) body fat (increases/decreases) total body water (increases/decreases)

A

decreases…increases… decreases

50
Q

Describe how changes in body fat and water content with aging affects drug metabolism

A

Fat soluble drugs

  • I.e diazepam
  • Prolongs the action of the drug
  • Decreased initial effect

Water soluble drugs

  • I.e acetaminophen
  • Exaggerated initial effect
  • Decreased duration
  • Reduce the dose in older people
51
Q

Baroreflex sensitivity (increases/decreases) with age leading to what consequences

A

decreases

  • Increased orthostatic hypotension
  • Decreased thermoregulation
52
Q

Aortic and carotid chemoreceptor sensitivity (increases/decreases) in eldery

53
Q

Caution with what types of drugs in older patients

A

-Anti-cholinergics (such as anti-depressants, anti-histamines, cold remedies, and anti-psychotics)

54
Q

Heart becomes (more/less) compliant with age due to…. which can cause

A

less…. increased CT this can cause pulmonary congestion (differs from traditional heart failure)

55
Q

T/F Digoxin a drug typically used in patients with heart failure is effective in patients with congestive heart failure caused by fibrosis

56
Q

Treatment for patients with heart failure caused by fibrosis is

A

diuresis and control of coexistant hypertension

57
Q

The valves in the heart most commonly affected by degenerative changes with aging are

A

aortic and mitral valves

58
Q

The most common cause of aortic stenosis for the first time in a 60+ year old is

A

degeneration of a normal aortic valve

59
Q

Older people with valvular disease are more prone to what other disease

A

atrial fibrillation

60
Q

Atrial fibrilation is an important cause of

A

congestive heart failure and increased risk for stroke

61
Q

People with arrhythmias that are older often require _ and are treated with what types of meds to prevent _

A

pacemakers… anticoagulants to preven thrombosis and embolism

62
Q

Most important pre-disposing factor to endocarditis is

A

previous disease

63
Q

T/F Most people diagnosed with endocarditis are 60 +

64
Q

prior to surgical treatment a pateitn on anticoagulants must have an INR

65
Q

T/F Generally a good ideal to get patients off their anticoagulants before surgery

66
Q

Drugs to be aware of if the patient has ventricular arrhythmia is

A

amiodarone

67
Q

Caution when prescribing patients with ventricular arrhythmias with _ because…

A

anti-fungals may prolong the QT interval potentially leading to malignant arrhythmias

68
Q

Caution using what instruments on patients with ventricular arrhythmias

A

ultrasonic and electrosurg in patients with pacemakers and defibrillators
Also avoid epi

69
Q

T/F Patients with endocarditis do not need to premed before dental appointments

70
Q

Why should patients with endocarditis have spaced out dental appointments?

A

allow time for antibiotic pre-med to clear to avoid drug resistance Other way to prevent resistance is alternate amoxicillin and clindamycin

71
Q

Elasticity of lungs (increases/decreases) with aging

72
Q

T/F Oral organisms may contribute to pulmonary infection in elderly

A

t- more at risk for lung infection pneumonias in older people often caused by oral microbes (significant cause of mortality for institutionalized elders)

73
Q

Preventing pneumonia caused by oral microbes can be done by…

A
  • Eliminate gross caries
  • Reinforce OH
  • Anti-bacterial rinse
74
Q

GI changes with aging: (increases/decreases) parietal cell function

75
Q

Gastric pH (increases/decreases) with age

76
Q

Gastric emptying rate (increases/decreases) with age

77
Q

Splanchnic blood flow is (increases/decreases) with age

78
Q

Absorptive surface of GI (increases/decreases) with age

79
Q

GI changes in elderly affect what regarding drugs

A

decreased absorption of most drugs given orally

80
Q

GFR in elderly (increases/decreases)

81
Q

Number of glomeruli in elderly (increases/decreases)

82
Q

Abilities to concentrate urine in elderly (increases/decreases)

83
Q

Inability to concentrate urine effectively in elderly puts them at greater risk for

A

dehydration

84
Q

After 40 liver mass decreases by about _% each year

85
Q

Reduction in liver mass results in what changes

A

lower plasma albumin levels, decreased microsomal enzyme acivity and slower hepatic flow

86
Q

Reductions in plasma albumin has what consequences with drugs

A

greater amounts of free or unbound drug which can cause a greater drug effect

87
Q

IGF levels in elderly (increases/decreases)

88
Q

Glucose tolerance in elderly (increases/decreases) as a result of

A

decreases… as a result of insulin increase

89
Q

IGF supplements results in what bodily changes

A

0leaner body mass

-Fat mass decreases

90
Q

Levels of NE, insulin and parathyroid hormone (increases/decreases) in elderly

91
Q

T/F Pre-med is indicated for diabetics

A

DEPENDS- if the patient is poorly controlled YES if well-controlled NO

92
Q

Difference in hematocrit and hemoglobin in elderly

A

women= increase
Male = decrease
**This is because with age marrow fat increases leading to decrease in active marrow but in women after menopause red blood cell mass increases
No real significant changes in hematocrite, hemoglobic, WBC, or platelet count

Geriatrics (11 decks)

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