2.4.3 Age/Gender Differences in CP Function

Question 1

What might be wrong with Mr. Green?

Answer 1

Aortic Stenosis

Question 2

What is the common pathophys behind diastolic HF?

Answer 2

Impaired myocardium relaxation due to lack of rapid intracellular Ca++ ion clearance from the cell by the SR ATPase. Actin crossbridges cannot release and myocardium cant relax

Question 3

What is diastolic HF?

Answer 3

The filling of the ventricles is impaired due to stiff ventricular walls, but emptying capacity is normal.

Question 4

What is atrial fibrillation?

Answer 4

Irregularly-irregular atrial pulse

Can lead to clotting issues

Question 5

How can you treat asthma?

Answer 5

Question 6

What is the target BP for those over 80?

Answer 6

Systolic of 150

Question 7

What are some of the normal cardiac changes that occur with age?

Answer 7

Widening of the aorta

LVH reduces diastolic filling

LV contraction is decreased

Question 8

Is it common to develop hypertension, despite never having it before?

Answer 8

Yes, the prevalence increases with age

Question 9

What are some characteristics of asthma?

Answer 9

Question 10

What are some causes of diastolic HF?

Answer 10

Impaired ventrilcular compliance

Tachycardia

Less atrial kick

Question 11

The image is characteristic of what?

Answer 11

LVH caused by aortic stenosis

Question 12

What is systolic heart failure?

Answer 12

Loss of contractile strength of the heart with compensatory ventricular hypertrophy or dilation

Lowered ejection fraction

Leading to lowered SV and CO

Question 13

What are the anatomical changes associated with pulmonary aging?

Answer 13

Increased lung compliance, less elastic recoil, closing volumes increase, more of smaller airways close, upper lung better ventilated, lower lung better perfused, more v/q mismatch.

Question 14

Patient has 60 pack year history of smoking. Physical examination yields the following on the attached image. What does she have?

Answer 14

COPD

Question 15

What is the treatment for A fib?

Answer 15

Anticoagulation to prevent stroke

Rate control to slow down fibrillation

Question 16

Patient has had cough and crackles in both lungs. CXR reveals the image attached. What do they have?

Answer 16

Pneumonia

Question 17

What can be the effects of a decreased B-adrenergic response?

Answer 17

Decreased cardiac output and HR response to stress which can lead to heart failure

Question 18

What can the effects be of decrease arterial compliance in elderly?

Answer 18

This will lead to increased systolic BP

They can have hypotensive response to increased HR, volume depletion, or loss of artial contraction. This can lead to passing out

Question 19

Patient is 65 yields the following physical exam. What do they have?

Answer 19

Asthma - know by the wheezing

Question 20

What can the effects of decreased baroreceptor sensitivity and decreased SA node automaticity?

Answer 20

Impaired BP response to standing and volume depletion leading to syncope and heart block

Question 21

What might the patient have?

Answer 21

Heart failure

Question 22

What is aortic stenosis?

Answer 22

Hardening of the aortic valve causing difficulty with blood flow

Question 23

How does A. Fib. affect a patients chances of having a stroke?

Answer 23

A. Fib. greatly increases a patients chances of having a stroke

Question 24

What are some causes of HTN?

Answer 24

Elastic artery stiffening associated with fracturing of the elastin protein, collagen proliferation and calcium deposition

Question 25

What is the leading infectious cause of death in older adults?

Answer 25

Pneumonia

Question 26

What is the pack-years associated with COPD?

Answer 26

greater than 40