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Geriatric exam > Ageing > Flashcards

Ageing Flashcards

1
Q

Ageing - Def

A

= the period of the lifespan characterized by a failure to maintain homeostasis under conditions of physiological stress.

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2
Q

Life span at birth for female?

A

79

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3
Q

Life span at birth for male?

A

74

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4
Q

Theories of ageing

A
  • Immunologic: diminishing effect of the immune system.
  • Cellular and transcription theory: limited ability to repair cells
  • Atmosphere: effect of UV light + activate the chemicals to cause cellular damage leading to ageing.
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5
Q

Biological & physiological theories of ageing

A
  • Wear & tear theory
  • Autoimmunity theory
  • Free radical theory
  • Programmed (cellular) theory
  • Somatic mutation theory
  • Homeostatic theory
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6
Q

! Characteristics of disease in old age

A
  • Rapid worsening and complications are common.
  • Multiple causes: one problem with many causes ➤ treat all the causes.
  • Variable presentation of disease ➤ Common presentations include: incontinence, falls, dementia and confusion ➤ Virtually any disease may present with these.
  • More time is required for recovery ➤ due to impairment in homeostatic mechanism and loss of physiological reserve.
  • Impaired metabolism and excretion of drugs: doses may need lowering to avoid side effects
  • Social factors: are important for quick recovery.
  • Multiple pathology: Ex: senile cataract + arthritis = falls
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7
Q

Examples of questions to ask in the Hx

A
  • Obtain home details ➤ stairs, access to toilet
  • Medication ➤ What? When?
  • Social input ➤ regular visitors
  • Type of care
  • Speak to others ➤ relatives, neighbours, GP
  • Plan and get involved in a care plan.
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8
Q

Geriatric assessment

A
  • Measurement of the knee height.
  • Nutrition ➤ Body mass index, Height calculation, Weight loss, Oral hygiene & dentition
  • Hydration ➤ Skin tumour, Oedema
  • Pulse ➤ Atrial fibrillation
  • Erect and supine blood pressure. ➤ Postural hypotension
  • Hearing ➤ Wax, Hearing aid
  • Vision ➤ Visual acuity, Glasses, Cataract
  • Cognitive function ➤ Abbreviated mental test
  • Muscles ➤ Wasting, Strength
  • Per rectum ➤ Faecal impaction, Prostate, Size, Consistency, Anal tone
  • Skin ➤ Wounds, Ulcer, Infection, Swelling
  • Joints ➤ Deformity, Pain, Swelling, ROM
  • Gait and balance ➤ Get up and go test
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9
Q

Abbreviated mental test

A
  • What is the time?
  • What year is it?
  • What is the name of the place …?
  • How old are you?
  • What is your date of birth?
  • Please memorise the following address- 6 Netherhall gardens
  • When did first world war begin?
  • Who is the present monarch?
  • Please count backward from 20 to 1?
  • Can you recognise 2 people?
  • Can you tell me the address I asked you to memorise a few minutes ago?
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10
Q

CNS - Changes with ageing & clinical consequences

A

Changes:

  1. Neuronal loss
  2. Cochlear degeneration
  3. Increased lens rigidity
  4. Lens opacification
  5. Anterior horn cell loss
  6. Dorsal column loss
  7. Slowed reaction time

Clinical consequences:

  1. Increased risk of delirium
  2. Presbycusis / loss of high tone hearing
  3. Presbyopia / abnormal near vision
  4. Cataract
  5. Muscle weakness & wasting
  6. Reduced position and vibration sense
  7. Increased postural instability (falls)
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11
Q

Respiratory system - Changes with ageing & clinical consequences

A

Changes:

  1. Reduced lung elasticity and alveolar support
  2. Increased chest wall rigidity
  3. Increased V/Q mismatch
  4. Decline in alveolar surface area (O2)
  5. Reduced cough and ciliary function

Clinical consequences:

  1. Reduced vital capacity and peak expiratory flow
  2. Increased residual volume
  3. Reduced inspiratory reserve volume
  4. Reduced arterial O2 saturation
  5. Increased risk of infection
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12
Q

CVS - Changes with ageing & clinical consequences

A

Changes:

  1. Reduced maximum heart rate
  2. Dilation of aorta
  3. Reduced elasticity of conduit / capacitance vessels/aorta
  4. Reduced number of pacing myocytes in sinoatrial node

Consequences:

  1. Reduce exercise tolerance
  2. Widened aortic arch on x-ray
  3. Widened pulse pressure + postural hypotension
  4. Risk of atrial fibrillation
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13
Q

Renal system - Changes with ageing & clinical consequences

A

Changes:

  1. Loss of nephrons
  2. Reduced glomerular filtration rate
  3. Reduced tubular function
Clinical consequences: 
1.	Impaired fluid balance
2.	Risk of dehydration and fluid overload
3.	Impaired drug metabolism and excretion  
Others: 
4.	Bladder capacity reduced
5.	Change in pelvic support
6.	Prostate enlargement 
7.	Urinary incontinence
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14
Q

Skin - Changes with ageing & clinical consequences

A

Changes:

  1. Thing and sparseness of hair
  2. Hair follicles produce less melanin
  3. Capillary fragility of skin
  4. Atrophy of sweat glands
  5. Decreased response to pain and sensation

Clinical consequences:

  1. Baldness
  2. Greying
  3. Pressure sore
  4. Temperature regulation issues
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15
Q

GI system - Changes with ageing & clinical consequences

A

Changes:
1. Reduced motility

Consequences:
1. Constipation

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16
Q

Bones - Changes with ageing & clinical consequences

A

Changes:
1. Reduced bone mineral density

Consequences:
1. Increased risk of osteoporosis

17
Q

Endocrine system - Changes with ageing & clinical consequences

A

Changes:
1. Deterioration in pancreatic B-cell function

Consequences:
1. Increased risk of impaired glucose

18
Q

Clinical concerns in old age - examples of conditions

A
  • Dementia
  • Delirium
  • Incontinence
  • Falls
  • Hypothermia
  • Postural hypotension
  • Stroke
Other less common conditions: 
o	Infection
o	Heart failure
o	Diabetes mellitus
o	Anaemia
o	Hypertension
o	Painful joints
o	Bone diseases
o	Atrial fibrillation 
o	Dizziness & black out
o	Peptic ulceration 
o	Immobility

Geriatric exam (5 decks)

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