65. Geriatric anesthesia

Question 1

CV changes in elderly

Answer 1

Increase of afterload, O2 consumption, wall stress

Question 2

Virchow triad

Answer 2

Stasis, increase coagulation, endothelial damage
Increase the incidence of VTE

Question 3

Heart changes in elderly

Answer 3

Most common.
Diastolic dysfunction, most dependent on preload and atrial kick.
A fib. Decrease kick, CO
Ast.

Question 4

Respiratory changes in elderly

Answer 4

Weakness of muscles that leads to respiratory depression
Increase compliance, decrease elasticity, that lead and increase of the FRC and the expense of the TV
V/Q mismatch
Decrease response to hypoxia/hypercapnia

Question 5

Kidney changes in elderly

Answer 5

Decrease in size, decrease GFR

Question 6

Liver changes in elderly

Answer 6

Decrease in size, hepatic blood flow, PONV, number of hepatocytes
Slow metabolization

Question 7

CNS changes in elderly

Answer 7

Dementia
No dopa antag (pramin), extrapyramidal side effects
No MAO inh, can cause seratonin syndrome
Propofol can cause dyskineas

Question 8

TLC in elderly

Answer 8

Increase of FRC ant the expense of TV, but TLC remains the same