2.4.3 Age/Gender Differences in CP Function

Question 1

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

Answer 1

Widening of the aorta

LVH reduces diastolic filling

LV contraction is decreased

Question 2

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

Answer 2

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 3

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

Answer 3

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

Question 4

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

Answer 4

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

Question 5

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

Answer 5

Yes, the prevalence increases with age

Question 6

What are some causes of HTN?

Answer 6

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

Question 7

What is the target BP for those over 80?

Answer 7

Systolic of 150

Question 8

What might the patient have?

Answer 8

Heart failure

Question 9

What is systolic heart failure?

Answer 9

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

Lowered ejection fraction

Leading to lowered SV and CO

Question 10

What is diastolic HF?

Answer 10

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

Question 11

What is the common pathophys behing diastolic HF?

Answer 11

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 12

What are some causes of diastolic HF?

Answer 12

Impaired ventrilcular compliance

Tachycardia

Less atrial kick

Question 13

What might be wrong with Mr. Green?

Answer 13

Aortic Stenosis

Question 14

What is aortic stenosis?

Answer 14

Hardening of the aortic valve causing difficulty with blood flow

Question 15

The image is characteristic of what?

Answer 15

LVH caused by aortic stenosis

Question 16

What is atrial fibrillation?

Answer 16

Irregularly-irregular atrial pulse

Can lead to clotting issues

Question 17

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

Answer 17

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

Question 18

What is the treatment for A fib?

Answer 18

Anticoagulation to prevent stroke

Rate control to slow down fibrillation

Question 19

What are the anatomical changes associated with pulmonary aging?

Answer 19

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 20

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

Answer 20

Pneumonia

Question 21

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

Answer 21

Pneumonia

Question 22

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

Answer 22

COPD

Question 23

What is the pack-years associated with COPD?

Answer 23

greater than 40

Question 24

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

Answer 24

Asthma - know by the wheezing

Question 25

What are some characteristics of asthma?

Answer 25

Question 26

How can you treat asthma?

Answer 26