Aging Physiology - Test 3 Flashcards
Describe three major changes seen in the cardiovascular system in old age.
- Stiff arteries -> increased systolic blood pressure, decreased diastolic blood pressure (higher pulse pressure), and increased afterload
- Left ventricular hypertrophy (from increased afterload and collagen deposition) –> 3. Impaired filling (can lead to dyspnea!) leads to atrial hypertrophy -> a-fib
Explain why max heart rate decreases with age.
There is decreased beta-1 responsiveness
Is there reduced nitric oxide activity in old age? What is the consequence of this?
Yeah - less vasodilation (endothelial dysfunction)
Is it normal for a brain to lose some volume over time?
Yeah
Is a mild loss of cognition normal in old age?
Yeah
Describe the changes to total lung capacity, residual volume, vital capacity, FEV1, and diffusion capacity that occur with old age.
TLC stays the same because the decreased compliance from kyphosis negates the decreased elastic recoil
Residual volume increases with age due to decreased elastic recoil
Vital capacity decreases due to reduced diaphragm strength and increased RV
FEV1 decreases because the diameter of small airways decreases
Diffusion capacity declines by 5%/decade after age 40
What is the medical term for the loss of muscle mass, often seen in old age?
Sarcopenia
What happens to TSH and thyroid hormone levels as we age?
They all drop
What happens to glucose tolerance as we age?
It drops due to fewer beta cells -> less insulin
What happens to renin and aldosterone levels as we age?
Drop
What happens to GHRH, GH, and IGF-1 levels as we age?
Drop
What normal physiologic change of aging predisposes old people to becoming hyponatremic?
Increased vasopressin/ADH secretion
Decreased ________ increases old people’s risk of dental caries, makes it harder to swallow, and makes food taste shitty.
salivation
Why are older people more susceptible to developing GERD?
Decreased tone of the esophageal sphincter
You see a 83 year old female with RA that is brought in by folks from the skilled nursing facility with an acute onset of ataxia and confusion (oriented to person but not time and place). She has diminished proprioception on exam. Blood smear shows hypersegmented neutrophils. Describe the pathophysiology of this woman’s condition.
She took NSAIDs to manage her RA –> gastritis –> damage to parietal cells –> no intrinsic factor –> no B12 absorption in the distal ileum (pernicious anemia) –> B12 deficiency anemia and neurologic sequelae
A 77 year old male presents to the ED with delirium. After some IV fluids, he calms down and you take a history. He states that he has had LLQ pain and tenderness and felt like he may have had a mild fever one day ago. CT scan shows pericolonic thickening of the sigmoid colon. Describe why older people are susceptible to this condition.
Messed up rhythmic contractions of the colonic mucosa –> constipation –> risk of diverticulosis and diverticulitis
Describe each type of incontinence:
Stress
Urge
Overflow
Functional
Mixed
Stress incontinence is when you piss a little while sneezing or lifting an object or something - due to decreased strength of pelvic floor muscles
Urge incontinence is when you piss a little because you suddenly had to piss super bad - due to detrusor muscle spasms
Overflow incontinence is when you’re a leaker - due to something like BPH where there is post-void residual, or fucked up detrusor muscle contraction
Functional incontinence is due to factors that don’t include the GU system (eg. immobility –> can’t get to bathroom in time)
Mixed is a mix of stress + urge incontinence
What happens to your senses with age?
They start to suck
