Aging

Question 1

Whats the diagnosis?

15 yr old male, easy brusing, fatigue, nose-bleeding, stopped growing with hyperpigmented macules on upper chest and neck. oral leukoplakia, dystrophic nails.
CBC: pancytopenia

which genetic mutaiton is it:
* Fanconi anemia
* Acute lymphoblastic leukemia
* dyskeratosis congenita
* diamond blackfan anemia
* chronic grnaulomatous disease

Answer 1

dyskeratosis congenita
genetic mutation affecting telomere maintenance
» short telomeres&raquo_space; premature celldeath in rapidly dividing cells. (mucocutaneous, BM, pulmonary fibrosis)

Question 2

what is telomerase?
what his function?

Answer 2

Ribonucleoprotein
function: adds DNA sequence repeats to chromosome ends (telomeres) = maintaning telo,ere length, particulary in stem cells.

Question 3

how does telomerase activity differ between stem cells and somatic cells

Answer 3

stem cells- higher activity
Somatic cells- lacking telomerase&raquo_space; telomere shortning&raquo_space; higher risk for cell death

Question 4

how does cancer cells affect telomerase activity?

Answer 4

up-regulation

Question 5

what happens to EPO during Aging of BM

Answer 5

stay the same
altough less blood cells are produce

Question 6

aging &acculmulaiton

what accumulate in cells with low regeneraiton capacity?

and in which cells can we see it

Answer 6

lipofuscin
(byproduct of lipid oxidation and and low lysosomal break due to free ROS)

Liver, heart, kidney, brain

Question 7

aging

what substance accumulaiton will cause myocardial atrophy?

Answer 7

connective tissue (interstitial) + Extracellular amyolid

Question 8

how does aging affect on immune cell divison?

on lympocytes

Answer 8

Loss lymphocytes telomere length > decrease production of naive B&T.

Question 9

how does aging affect the division into subtypes of lympocytes?

Answer 9

less naive cells&raquo_space; those cells become more memory cells&raquo_space; less B&T for new antigens&raquo_space; Higer risk for vaccine failure & infections

Question 10

Aging & liver

What age related changes occur in the liver affecting drug metabolism?

Answer 10

1. reduce liver mass (lower hepatic blood flow)&raquo_space; less ability to metabolize drugs
2. Decrease expression of CYP450

Question 11

Does aminotransferases level changes by aging?

Answer 11

no
remain the same in helaty elderly

same for: BL, ALP, GGT

Question 12

Aging & eyes

what is presbyopia

Answer 12

age related loss of lens elasticity, affecting near vision focus

Question 13

what is myopia?

Answer 13

nearsightedness, impedes your ability to see distant objects clearly

Question 14

how does presbyopia affect mild myopia?

Answer 14

adjust image focus onto the reting&raquo_space; Offsetting myopia effect

Question 15

Aging &skin

what are UVA and UVB (UV light)

Answer 15

UVA- trigger ROS formation&raquo_space; inf. and collagen & elastin break&raquo_space; thinning and wrinkles
UVB- causing sunburn and higher risk cancer

B= באסה נשרפתי
A= אעעעע יש קמטים

Question 16

Aging & reproductive

How does man sex decline comapre to female menopause?

Answer 16

testosterone in man&raquo_space; slower and variable declinning comapre to rapid hormone drop in womens

Question 17

what hormonal changes aging mans exprerience?

Answer 17

decrease testosterone
higher LH
higher SHBG

Question 18

what sexual changes common in aging man

3

Answer 18

1. reduce volume
2. longer erectile latency
3. more stimulation needed for erection

Question 19

which 2 symtoms indicate low testosterone level?

Answer 19

1. reduce libido
2. erectile failure

Question 20

aging &cardiovascular

How does aging affect afterload

Answer 20

increase afterload&raquo_space; increase SBP&raquo_space; higher PP (SBP- DBP)

Question 21

what happens to the aorta during aging? what is the consequence?

Answer 21

arotic root dilation+ elastin to collagen&raquo_space; stiffer aorta&raquo_space; increase afterload&raquo_space; increase SBP

Question 22

what are the two main changes in aging on the heart?

and how the heart compensate?

Answer 22

1. increased afterload
2. loss in cardiomyocyte number

compensation:
Concentric LVH&raquo_space; systolic S4 (physiological in elderly)&raquo_space; LA enlargment (backflow)

Question 23

How does elderly affect the adrenergic responsivness?

Answer 23

decrease adrenergic responsivness&raquo_space; reduce baroreceptors sensetivity > orthostasis Hyptotension

Question 24

what arethe changes in occur in the lung with aging?

Answer 24

1. Increase dead space
2. Ventilation perfusion mismatch

due to elastin degradation&raquo_space; muscle remodling&raquo_space; chest wall stiffness

Question 25

How aging affect lung complience?

Answer 25

1. Decrease chest wall compliance
2. increases lung compliance

Question 26

how aging affect TLV and RV

Answer 26

TLV- constant
RV- increases

Question 27

How aging alter force VC (vital capacity)

Answer 27

reduce FVC (due to increase RV)

Question 28

how aging affect on high altitude?

Answer 28

impair adaptation , due to decrease chaset and alveolar compliance

Question 29

how aging affect atrial PO2 and PCO2

Answer 29

O2- lower
CO2- no change

Question 30

which of the following paramters chenge during elderly?
* TLC
* FVC
* RV
* Lung complaince
* Total respiratoy sys. compliance
* Physiological dead space

Answer 30

• TLC- unchange
• FVC- decrease
• RV- increase
• Lung complaince- increase
• Total respiratoy sys. compliance- decrease
• Physiological dead space- increase

Question 31

Aging + orophyryngeal

all of the following can cause an increase risk of ____________

reduce saliva, receding gums, wekaer swalloing muscles, impair taste and smell

Answer 31

Dysphagia

Question 32

Why there is a reduce saliva in aging?

Answer 32

Amyloid deposition in acinar glends

Question 33

why are imapired reflexes significant in elderly dysphagia?

Answer 33

1. increase risk for aspiration
2. impare airway protection

Question 34

what the different in drug metabolisim between Neonates and Elderly?

Answer 34

neonates- higher body water content and low fat = large volume distribution for water soluble drugs