Aging

Question 1

2/3rds of medical expenditures

Answer 1

last 1/3 of life

Question 2

what percentage of the population is over 85

Answer 2

1. 4% in 1990

2. 4% in 2030

Question 3

by 2050 what % of the population will be over 65

Answer 3

1/3

Question 4

rule of fourths

Answer 4

1/4 disease
1/4 disuse
1/4 misuse
1/4 physiological changes

four reasons people age

Question 5

disuse

Answer 5

sedentary lifestyles bread diseases like obesity

Question 6

decrease in response to stimuli

Answer 6

characteristic of aging that results in

decreased hearing
reduced taste
reduced smell
reduced reflex

Question 7

epigenetic changes

Answer 7

genes present themselves differently depending on environmental stimuli

Question 8

four age related physical changes

Answer 8

BP regulation: orthostasis
volume regulation : dehydration
thermoregulation:colder
impaired immune response –> increased infection and cancer

Question 9

changes in HR seen with agre

Answer 9

195 to 155

Question 10

kidneys reduced profusion by ____ in aging

Answer 10

50%

this is important because of medications that are renally cleared

Question 11

GI changes in aging

Answer 11

reduced peristalsis and secretions

Question 12

reductions in these sleep stages are seen in the elderly

Answer 12

3 and 4

Question 13

size of the prostate gland increases by

Answer 13

100%

Question 14

CKD is the ___leading cause of death

Answer 14

8th

Question 15

changes seen in the brain

Answer 15

loss of brain parenchyma

enlargement of ventricles

widened sulci

Question 16

Osteophytic changes

Answer 16

in osteophytes (bone spur) –> pain

Question 17

CHF

Answer 17

PA chest

interstitial pulmonary edema

cardiomegaly

redistribution of pulmonary blood to the upper lungs

increasing the likelihood of pneumonia if backing up from the left side of the heart

Question 18

leading cause of death

Answer 18

CHF

Question 19

causes of CHF

Answer 19

infection

valve infection

high blood pressure is the most significant

Question 20

ejection fraction

Answer 20

measurement that determines CHF

Question 21

blood back up in the right side of the heart leads to…

Answer 21

pitting edema legs
liver and
digestive organs

Question 22

Occam’s razor

Answer 22

simpler explanation is better this does not apply in atypical presentations of diseases

seldom is a unifying diagnosis possible must assume things are multifactorial

Question 23

iatrogenic if the ______ leading cause of death

Answer 23

1/3

Question 24

causes of death 1-10

Answer 24

1. heart dz
2. cancer
3. iatrogenic
4. COPD
5. accidents
   5 CVA
   6 dementia
   7 diabetes
   8 PNA
   9 CKD
   10 suicide

Question 25

Influenza vaccine

Answer 25

1qyr

Question 26

tetanus

Answer 26

1q10

Question 27

varicella

Answer 27

2 doses if pt has ever had varicella

Question 28

zoster

Answer 28

1

Question 29

MMR

Answer 29

1 dose if never had the dz

Question 30

pneumococcal

Answer 30

1 dose unless high risk then 1q5yr

Question 31

hepatitis A

Answer 31

only if high risk

Question 32

breast cancer screening

Answer 32

biennal mammography 50-74 yo>75 no evidence

Question 33

colon cancer

Answer 33

FOBT fecal occult blood test annual 50-75 yo

Question 34

GIB

Answer 34

gastrointestinal bleed seen as the iatrogenic COD with prescribed blood thinners

Question 35

cervix and prostate screenign

Answer 35

no screening over 65yo exception is if a female has never had a pap the no pap if there are 2x negative paps

Question 36

brain weight decreases by what percentage in elderly

Answer 36

7% due to atrophy

Question 37

cardiac maximum function in elderly is typically seen as

Answer 37

going from 195 to 155 bpm

Question 38

bone mineral content decreases by

Answer 38

10-30

Question 39

interstitial pulmonary edema, cardiomegaly, and redistribution of pulmonary blood are all common findings in this aging dz

Answer 39

chf

Question 40

colon cancer screening for pts 76-85

Answer 40

not routine

Question 41

colon cancer screening for pts >85

Answer 41

no screening

Question 42

Majority of 65yo plus have how many prescriptions?

Answer 42

over 5 rx

Question 43

how many individuals over 65 have ADE

Answer 43

1/3

Question 44

what % of population has AKI

Answer 44

2/3 of pt over 65 yo

Question 45

what specialist referral do you make following an elderly fall

Answer 45

: neuro (hydro) cards (arrhythmia), ortho spine (stenosis)