Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

s4 - Repro, Develop, Ageing, Pharm > AGE - SYSTEMS > Flashcards

AGE - SYSTEMS Flashcards

1
Q

Name 3 changes in the heart muscle with age:

A
  • ventricular myocytes hypertrophy (increased afterload)
  • fibrous tissue deposited
  • amyloid deposits
  • LV cavity slight enlargement
  • LA hypertrophy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What happens to the heart valves as we age?

A

-thicker, calcified, less flexible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Suggest how/why conduction of electrical impulses in the heart are affected with age.

A
  • less pacemaker cells
  • fibrous/fat/amyloid infiltrates
  • hypertrophy means slower propagation of impulses
  • intrinsic HR reduces
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Less cardiac contractility, max HR and less blood vol. in LV with ageing leads to what?

A
  • lower CO reserve
  • CO cant increase upon stress/exercise as much
  • orthostatic hypotension and activity intolerance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How are vessels affected with age? NO? Atherosclerosis? Compliance?

A
  • less NO from endo (NO=protective from atheroma)
  • endo. dysfunction -> ath.sclerosis
  • arteries get stiffer, less elastin -> less compliant
  • collagen & calcifications increase stiffness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is lipohyalinosis that can occur in ageing vessels due to microvascular damage to them?

A

-narrowing of vessels by wall thickening, eventually block off supply (e.g. to eye/brian/kidney)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Because of changes in the CVS with age, HT, CHD, MI, Stroke…are more common. Name 3 modifyable risk factors that affect these?

A
  • BP
  • Diabetes
  • Dyslipidaemia
  • Smoking, alcohol
  • PA, stress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Give 2 reasons the chest wall stiffness increases with age:

A
  • less elastin
  • calcification
  • more Conective Tissue
  • muscle stiffness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How is the thorax compressed with age lowering FEV1 and FVC?

A

-degenerative narrowing of IV disc spaces -> kyphosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does the cough reflex change with age?

A
  • less sensitive reflex

- weaker muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why does mucociliary clearance decrease with age?

A
  • less no. cilia

- cilia are slower. less efective, take longer to recover post-insult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Less elastic recoil of alveoli cause small airways to collapse, any other alveoli changes?

A
  • reduced elastic tissue -> thinner and shalllower

- less SA for exchange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does the diameter of respiratory bronchioles and alveolar ducts dilating with age affect air/inflation? (aka senile emphysema)

A
  • get premature closing of small airways during normal breathing
  • airtrapping and hyperinflation occurs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What pathology can vascular remodelling of vessels within lungs, more pulmonary stiffness/pressure/resistance contribute to?

A
  • more pressure on R-Heart

- Right sided HF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is homeostenosis? E.g. in response to insult

A

-an insult withstood in younger people pushes elderly beyond their functional capacity - > decompensation, disease and death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Give 2 ways in which the kidney ages structurally?

A
  • less renal mass,
  • more fat and fibrosis
  • tubular atrophy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Give 2 ways in which the kidney ages functionally?

A
  • less compliance (as intimal fibrosis) less blood flow
  • sclerosis of cortical nephrons -> non-functioning
  • less renin, aldosterone, lower GFR
  • poorer concentrating capacity (poor Na+ excretion)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What contributes to the poorer ability to maximally dilute urine and excrete water load with age?

A
  • decreased max. urine osmolality
  • decreased total body water
  • decreased response to thirst
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What do the 5 Is of Presentation of unwell Older people stand for?

A
  • Immobility
  • Instability
  • Intellectual Impairment
  • Incontinence
  • Iatrogenic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

List 2 consequences of immobility in older unwell people:

A
  • pressure ulcers
  • pneumonia
  • dependence, death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

List 2 consequences of instability in older unwell people:

A
  • fractures
  • immobility
  • fear of falling
  • traumatic intercranial haemorrhage, dependency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Delerium is a common syndrome characterised by what? (presentation, onset, course)

A
  • disturbed conciousness, cognition or perception
  • an acute onset
  • fluctuating course
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the 4 types of urinary incontinence?

A
  • urge
  • stress
  • mixed
  • functional
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the response to cold? List receptors, and 2 responses

A
  • central&periph thermal receptor send info to hypothal
  • shivering
  • More thyroid, catecolamine, adrenal activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Shivering produces heat and increases what 3 things in the body?

A
  • metabolism
  • ventilation
  • CO
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is “cold diuresis” why does it happen?

A
  • cold induced increased urination to preserve heat

- vessel constriction to have less BF to skin, more to internal organs causes more fluid volume in core -> urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Give 4 reasons the elderly are at an increased risk of developing hypothermia and its complications:

A
  • less subdermal fat
  • less shivering (sarcopaenia)
  • social isolation, cognitive impairment
  • chronic endocrine disease
  • reduced physiologival reserve
  • medications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are some possible causes of an Osborn/J wave on an ECG? (as well as a normal physiological variant..)

A
  • low temperature
  • hypercalcaemia
  • medications
  • neuro insults (nitercranial HT, subarach haemorr.)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What growth factor made by osteocytes causes less vit D activation? What efefct does this GF have on phosphate levels?

A

FGF-23

Causes phosphate excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What do osteoblasts differentiate from?

A

Mesenchymal stem cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are osteoclasts derived from?

A

Heamatopoetic Stem Cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What cell controls the balance of osteoblast:osteoclast activity? What are these cells terminal derivations of?

A

Osteocytes

-derived from osteoblasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Via what network do osteocytes communicate with eachother and with surface cells and systemic circulation?

A

The Lacunar-Canaliculi Network

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Give an example of facotrs favouring bone reabsorption and what favours formation?

A
  • unloading favours resorption (bed-rest)

- loading like weight-exercise favours formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Name 3 actions of PTH. e.g. stimulates bone remodelling (both ana & cata -bolic)

A
  • released when Ca2+ is low
  • stimulates 25-OH D3 to active vit D3 in kidney via 1-a hydroxylase
  • stimulates Ca absorption in renal tubule, (phos. excretion)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Give 2 actions of vit D in terms of bone remodelling

A
  • more Ca and phos. absorption from gut
  • promotes osteo-clast/blast differentiation
  • inhibits PTH release and 1-a hydroxylase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the action of Calcitonin??

A
  • decreases Ca2+ when high

- inhibits osteoclast function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What effect does oestrogen have on the lifecycle of osteoclasts and osteoblasts?

A
  • osteoclasts: promotes apoptosis

- osteoblasts: protects vs. death so more bone made

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What effect does oestrogen have on oesteoclast differentiation?

A

Indirectly inhibits it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Receptor Activator of Nuclear Factor Kappa-B (RANK) is a surface receptor on which cells? Stimulating..?

A
  • receptor on pre-osteroclasts

- stimulates osteoclast differentiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

RANK-ligand is made by: pre-osteoblasts, osteoblasts and osteocytes. What does it stimulate when bound to RANK?

A

-osteoclast differentiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Osteoprotogerin (OPG) is released by osteocytes, what is its effect in binding to RANK-ligand?

A
  • its a decoy receptor

- by binding to RANK-ligand it competes for RANK so downregulates osteoclasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Sclerostin prevents the activation of the Wnt pathway, what effect does this have on osteoblast formation?

A
  • sclerostin inhibits osteoblast formation

- as o.blast differentiation involves Wnt pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Osteomalacia is a loss of bone mineralisation. What is osteoporosis?

A

-loss of mineral and organic bone mass and density

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

List 3 causes of osteoporosis…age-related, endocrine…

A
  • malignant bony metastasis
  • systemic PTH-related hormone releasing tumour
  • drug induced (glucocorticoids)
  • end stage kidney disease
  • inadequate nutrition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

List 3 endocrine causes of osteoporosis:

A
  • hypogonadism (/oestrogen deficiency)
  • excess glucocorticoids (endo/exo.genous)
  • hyperparathyroidism - benign PT tumour secreting
  • hyperthyroidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

How is osteoporosis diagnosed?

A
  • Bone Mineral Density (BMD) measured
  • DEXA of e.g vertebrae, NOF
  • T score -2.5 or lower
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Risedronate and alendronate are examples of what class of drugs used to treat osteoporsis by inhibiting osteoclasts?

A

-Bisphosphonates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Denosumab is a mab against what? (used to treat osteoporosis by inhibiting osteoclasts)

A

-mab vs. RANK-ligand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Before pharmacological treatments of osteoporosis, what 2 things should be checked/confirmed?

A
  • adequate calcium and vit D intake

- sufficient/appropriate exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What are the guidlines for HRT for menopause?

A

-short term (3-5yrs) to treat vasomotor symptoms at lowest effective dose is good

52
Q

A “fall” is

A

unintentional/unexpected loss of balance

53
Q

Give 2 most common causes of a fall in the elderly

A
  • incorrect shifting of weight

- trip/stumble

54
Q

What does the pneumonic ACE stand for in factors contributing to an elderly falling?

A

A-Age related changes
C-Comorbidiities
E-Environment

55
Q

What age-related neurological changes occur that contribute to the risk of falling?

A
  • loss of neurones, brain weight decreases
  • neurones shrink, less connections
  • more demyelinated neurones (slower)
  • sensory impairment esp. extremities
  • impaired vestibular system
56
Q

What age-related muscular change occurs that contributes to the risk of falling?

A
  • sarcopaenia (loss of muscle strength and mass)

- more loss in legs vs arms

57
Q

What age-related postural changes occur that contribute to the risk of falling?

A
  • CT becomes less elastic
  • weaker muscles
  • changes C.o.G. so harder to maintain postural stability when walking
58
Q

What age-related gait changes occur that contribute to the risk of falling?

A
  • reduced speed from 70yrs
  • stride length shortens as calf muscles weaker and double support phase longer than swing
  • reduced hip flexion/extension
  • wider based gait
59
Q

What are some co-morbidities for falling?

A
  • stroke, arthritis, anaemia
  • visual impairment
  • dementia, delirium
  • othostatic hypo, post prandial hypo
  • incontinence (going at night)
60
Q

List some class of drugs that may increase the risk of falls:

A
  • benzodiazepines
  • hypnotics, sedating anti-depressants
  • opiates
  • anti-epileptics
  • diuretics
  • alpha, beta-blockers
  • antihistamines
61
Q

List 3 extrinsic factors that may increase the risk of falls:

A
  • lighting
  • rails, mobility aids
  • headroom
  • rugs/carpets
  • clothing/footwear
62
Q

Falls can cause injuries and 2dry disease like infections, pressure sores, pain..what psychosocial consequences can falls cause?

A
  • fear of falling
  • decreased confidence
  • loss of independence
  • low mood, social isolation
63
Q

To prevent falls we need to identify those at risk, assess the risk, reduce it and maintain this. Suggest ways to do these things..

A

..routinely ask, do a multifactorial risk assessment

  • make an individualised intervention plan
  • strenth/balance excercise program
  • home hazard assessment
  • eyesight and medication reviews
64
Q

1 in 3 hip fractures die within the yr. 50% permanently disabled. Where is a hip fracture anatomically?

A

-break in upper quarter of proximal part of femur

65
Q

What is a frailty fracture? A common one/site?

A 
Fractures that occur as a result of normal activities (fall from standing height) 
Colles fracture (radius)
66
Q

Hip fracture presentation on examination is usually..

A
  • shortened and ext. rotated leg
  • pain on movement
  • cant weight bare
67
Q

An intracapsular hip fracture is the neck of femur. repaired by hemiarthoplasty. What are 2 extracapsular hip fractures, what surgery?

A
  • Trochanteric - dynamic hip screw

- Sub-trochanteric - Intramedullary nail

68
Q

List 4 post. hip operation complications in the elderly:

A
  • infection (pneumonia, wound)
  • reduced mobility, pressure sores
  • prosthesis failure
  • delerium (1 in 2)
  • heart disease, thromboembolism
69
Q

What is the somtopause in regards to the ageing endocrine system?

A
  • general decrease in protein syn., less GH
  • decrease muscle mass and M.Rate (less IGF-1)
  • more adipose deposition
  • reduced BMD, more osteoporosis risk
  • general decline in immune function
70
Q

How does thyroid hormones secretion change with age? Effect?

A
  • less T4 secretion, also less T4 hepatic excretion
  • serum T3 and TSH decline so reduced BMR
  • more autoimmune pathologies
71
Q

What co-morbidities or medication affect thyroid hormones?

A
  • HT, COPD, Diabetes

- Steroids, Lithium

72
Q

How is the endocrine pancreas affected with age?

A
  • ageing cells less sensitive to insulin
  • B cells need higher BG to trigger insulin release
  • more B cell apoptosis
  • more insulin excretion from liver
73
Q

What happens to the ageing adrenal gland in terms of aldosterone secretion and effect?

A
  • less aldosterone, poor controlled BP more postural hypotension
  • hyponatraemia contributes to this
74
Q

An adrenal crises “Addisonian-like Crises” is a triad of what? NB: this is precipitated by infection, vomiting, major surgery…

A

-Hypoglycaemia, Hyponatraemia, Hypotension

low sugar, low salt, low BP

75
Q

How does an adrenal crises “Addisonian-like Crises” present? How is it treated?

A
  • confusion in the elderly and rapid clinical decline

- IV fluids and hydrocortisone (+IV glucose)

76
Q

Osteoporosis is often primary, more osteoclast vs blast activity. What diseases may it be 2dry to?

A
  • parathyroid disease
  • hyperthyroidism
  • Cushing’s
  • low testosterone
77
Q

What happens to the pineal gland with age? Effect?

A
  • it calcifies

- melatonin changes -> sleep disturbance and cognitive impairment

78
Q

What does the adropause refer to?

A

Less testosterone with age so lower libido, BMD, muscle strength

79
Q

Testosterone can be given to improve the symptoms of the adropause, when is it contraindicated?

A

Prostate Cancer

80
Q

How does the epidermis change with age? Consequence?

A
  • less sebum produced
  • epidermis thins and dermo-epidermal junction flattens
  • more risk of infection
81
Q

What factors cause older adults to have poorer ability to thermoregulate? More heat retention and quick dehydration?

A
  • dermal thinning
  • reduced moisture retention
  • decreased ability to vasodilate capillary bed
  • hypothalamic dysregulation making higher thirst threshold
82
Q

How does pain and touch sensation change with age in the skin?

A
  • less nerve endings due to dermal thinning so less sensation
  • more neuropathic pain esp. if diabetes/micronutrient defieciencies
83
Q

How does the endocrine (vit D, melanin) function of the skin change with age?

A
  • less ability to make both vit D and melanin so more skin cancers
  • less vit D so more fracture risk
84
Q

How does the cycle of deconditioning with falls leading to incontince go..

A
  • fall -> fear of falling -> altered gait
  • limit world, walk less, less able, risk of immobility
  • > more pressure injuries, cant get to toilet
  • incontinence and more skin irritation here
85
Q

What is a pressure injury?

A

-ischaemia/necrosis of soft tissue thats compressed between a body prominence and a hard surface occluding the blood supply

86
Q

An ulcer is a “cone” injury, what does this mean?

A

-the wide base of cone is next to bone, tip is on surface what you see (injury worse than looks)

87
Q

What are moisture lesions? (NB: treat with barrier creams)

A
  • v. red/irritable lesions on skin surface often due to urine/stools or between skin folds
  • only superficial, no necrosis
88
Q

As moisture and pressure sores indicate immobility, poor nutrition or unmet care needs, what should be done?

A

Hollistic review

89
Q

What is xerosis and why does it occur in older adults v commonly?

A
  • dry skin

- less moisture retention and less sebum

90
Q

What is xerosis worsened by in older adults? any conditions?

A
  • AC, sitting by fire, soaps, rough clothing

- hypothyroidism, CKD, malnutrition, dermatisis

91
Q

What is itchy skin often associated with? As such what is the first step in treatment…

A

-associated with dry skin-so treat the dryness first

92
Q

Itchy skin can arise from what haematological conditions?

A
  • IDA (iron deficient anaemia)
  • polycynthaemia
  • leukaemia
  • lymphoma
93
Q

What medication can cause skin itchiness?

A

-opiods

94
Q

Small vessel vascuilitis presents how? Diagnosis by histoliogy showing..?

A
  • “purpura” - raised palpable purple areas

- inflamed vessels on histology

95
Q

What is pemphigoid on the skin? Consequences?

A
  • intense dense large blisters from dermal layer

- can -> dehydration, hypothermia, pain

96
Q

How are pemphigus and pemphigoid treated? What are the risks of the medication..

A

Steroids

  • e.g. DM: can they check sugars? Administer med? Recognise hypos? Call for help?
  • can you adjust dose?
  • do they need to be an inpatient
97
Q

What is cellulitis skin infection associated with? Onset? Presentation?

A

-associated with fevers and sepsis
-rapid onset, unilateral progressive redness
(NB: bilateral v.v.v. rare)

98
Q

As cellulitis is often caused by a pathogen gaining entry beneath skin, what questions are important to ask?

A
  • check between toes, ensure good foot care
  • ask about skin breaks
  • insect bites
  • adequate moisture barrier?
99
Q

What is the inflammatory condition “Lipodermatosclerosis” of the lower limbs usually due to?

A

Chronic Venous Insufficiency

100
Q

Presentation of Lipodermatosclerosis (due to chronic venous insufficiency)?

A
  • deep red colour
  • acute flares -> red, painful, scaly, bilateral
  • if chronic, brown haemosiderin may be deposited on insides of leg
101
Q

Name 4 causes of swollen legs?

A
  • fluid overload
  • dependent oedema
  • low-protein states
  • lymphodema
  • drugs
102
Q

Fluid overload-> leg swelling is a consequence of what? Presentation? Treat underlying cause.

A
  • HF (history important)
  • swelling of skin with sub-cut. fluid
  • bilateral and pitting
103
Q

Dependent oedema looks similar to fluid overload, whats the difference? Where does it present?

A
  • seen where gravity is, no relation to HF
  • reduces with elevation above heart level
  • doesnt ~go above knees
104
Q

Low protein states -> nephrotic states, severe protein malnutrition..where will oedema be? What will urine dipstick show?

A
  • all extremities, inc. hands, face, arms

- dipstick protein = +++

105
Q

Drugs can cause fluid retention by interupting lymphatic drainage, give an example of a drug that may do this?

A

-antihypertensives e.g. amlodipine

106
Q

Lymphodema causes swelling of legs, can be 1ry or 2dry. How does it present?

A
  • chronic, thick skin, cracked skin

- squaring of the toes

107
Q

Give 3 conditions which may lead to 2ndry Lymphodema?

A
  • lymph node surgery
  • severe cellulitis
  • inflam. conditions (RA, exzema)
  • venous disease -> overflow of fluid to lymph system
108
Q

What changes occur in the oesophagus with age?

A
  • slower peristalsis

- oesophageal sphincters lose tension so less contraction

109
Q

There are many links between poor mouth care and systemic diesease. Name some signs of an unhealthy mouth:

A
  • ulcers
  • thrush
  • bleeding/swolllen gums
  • tooth decay
  • dry mouth (xerostomia)
110
Q

Give 3 ways to manage xerostomia (dry mouth)?

A
  • frequent sips of cold water
  • sugar free chewing gum
  • water based moisturising sprays
  • sugar intake control
  • daily thrush check
111
Q

Enteric NS neurodegenerates with age but gut transit time is unaffected. What is gut transit time v. sensitive to changes in?

A
  • Thyroid hormone concentrations

- can be clinically prolonged transit time even in sub-clinical hypothyroidism

112
Q

What changes lead to more foecal incontinence in older adults?

A
  • reduced rectal wall elasticity
  • tonic activity of ext. sphincter is lost at a smaller volume
  • max. resting anal pressure and max. squeeze pressure decrease with age
113
Q

Nutrition support is for malnourished patients, how are these defined?

A
  • BMI<18.5, >10% unintentional weight loss in 3-6m
  • eaten little/nothing in last 5+ days
  • poor absorpative capacity
  • sepsis as increased catabolism…
114
Q

How does appetite change in older adults?

A
  • eat less, usually only 1/2 the plate

- eat more from high contrast colour plates

115
Q

If an older adult has lost a lot of weight, what 3 questions are important to ask?

A
  • was it intentional
  • how much have you lost
  • since when?
116
Q

What are common causes of unintentional weight loss?

A
  • malignancy (20%)
  • psychiatric disorder
  • GI disease
  • Hyperthyroidism (10%)
  • CV
  • nutritional/alcohol
117
Q

How is constipation defined?

A
  • hard stool more than once every 3 days
  • difficulty initiating evacuation
  • feeling of incomplete evacuation
118
Q

How is constipation managed in older adults?

A
  • more dietary fibre
  • enough water intake
  • maintain mobility where poss
  • regular toiletting (use gastro-colic reflex)
119
Q

How do Bulk forming Laxatives e.g. Fybogel work?

NB: cant take with opiods

A
  • enable fluid to be retained in faeces
  • increase peristalsis
  • useful in patient with decreased ano-rectal tone
120
Q

How do osmotic laxatives e.g. lactulose, macrogels and phosphate enemas work?

A

-soften stool by increasing water in bowel from elsewhere

NB: lactlulose -> bloating

121
Q

How do stimulant laxatives e.g. Bisacodyl and Senna work?

A
  • stimulate nerves that control muscles lining GIT

- causes muscle in large bowel wall to squeeze harder

122
Q

How do stool softener laxatives work e.g. Docusate?

A

-“surface wetting agent” so surface of stools is permeable and water can be absorbed to increase the water content

123
Q

What are 3 possible complications of constpation?

A
  • urinary retention (as bladder neck compressed)
  • overflow diarrhoea
  • bowel obstruction and perforation
124
Q

How may constipation impact someones quality of life?

-significantly interferes with many aspects of daily life..

A
  • mood
  • mobility
  • normal work
  • recreation
  • enjoyment of life
125
Q

Give structural and neurological abnormalities that may lead to Foecal Incontinence?

A
  • Structure: anorectal abnormalities (sphincter trauma, rectal prolapse), congenital abnormalities
  • Neuro: MS, stroke, pudendal neuropathy
126
Q

Management of Foecal Incontinence depends on the cause, suggest some ways?

A
  • gastro colic reflex and regular toilleting
  • stool sample to rule out infection
  • sigmoidoscopy if doesnt settle
  • pelvic floor exercises
  • laxatives e.g. loperamide, enema for overflow

s4 - Repro, Develop, Ageing, Pharm (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions