Comprehensive Geriatric Assessment Flashcards

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1
Q

What are the two parts of the CGA?

A

Multidisciplinary evaluation where multiple problems are considered…to develop a coordinated care plan

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2
Q

What is the purpose of the CGA? (3)

A
  1. Prevent decline in performance of ADLs and IADLs
  2. Screen for impairments
  3. Screen for preventable disease
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3
Q

What are the three pros to the CGA?

A

Improves function
Improves QOL
Decreases hospitalization

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4
Q

What are the members of a geriatric assessment team?

A

CMA/RN
Social worker
PharmD
Dr.

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5
Q

What are the IADLs?

A

Telephone
Transportation
Meds
Finances

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6
Q

What are the five areas of the GSA?

A
  1. Medical
  2. Function
  3. Psych
  4. Social
  5. Environment
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7
Q

What are the parts of the psychosocial assessment?

A

Cognitive assessment

Mood/depression testing

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8
Q

What are the five parts of the medical assessment?

A
Problem list
Comorbid conditions
Disease severity
Medication review
Nutritional status
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9
Q

What are the four parts of the functional assessment

A

ADLs
IADLs
Activity/exercise
Gait/balance

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10
Q

As pts lose the ability to do IADLs., then how likely are they to develop dementia?

A
1 = 1
2= 2.34
3 = 4.54
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11
Q

What percent of the elderly population have nutritional disorders?

A

20-30%

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12
Q

What are the lab tests used to check for nutritional status?

A

ALbumin

cholesterol

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13
Q

What is the get up and go test? What is considered a failure?

A

Pt has to get up from a seated position walk 10 ft, then return

Fail if more than 20 secs

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14
Q

True or false: the get up and go test is still valid for pts using an assistive device

A

False

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15
Q

What are the two parts of the psych assessment?

A
  1. Look for atypical presentation of depression

2. Assess cognitive function

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16
Q

What are the risk factors for depression? (2)

A

h/o social isolation

recent losses

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17
Q

What are the tools to assess cognitive function?

A
  1. Folstein mini-mental state exam
  2. Montreal cognitive assessment
  3. Clock draw
  4. Verbal fluency
  5. Mini-cog
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18
Q

What is the karnofsky scale?

A

Assessment for cognition

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19
Q

True or false: you should involve family members at a f/u meeting for cognitive deficit findings

A

True

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20
Q

What are the two goals of geriatric prevention?

A
Increase function (ADLs, IADLs)
Improve QOL
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21
Q

What is the secondary form of disease prevention?

A

Screening/detecting of asymptomatic

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22
Q

What is the tertiary form of disease prevention?

A

Treating complications

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23
Q

What is the primary form of disease prevention?

A

Immunization

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24
Q

What is the cost of missed prevention opportunities?

A

$55 billion

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25
Q

What is the cost of unnecessary services?

A

$210 billion

26
Q

What are the top three causes of death in the elderly as of 2010?

A

CA
Heart disease
LRIs

27
Q

What is the purpose of the USPSTF?

A

Determine whether or not evidence supports providing a clinical preventive service

28
Q

What does the “C” rating by the USPSTF mean?

A

Clinicians may provide this service to selected pts

29
Q

What does the “I” rating by the USPSTF mean?

A

Evidence that the service effectiveness is lacking, poor quality

30
Q

What are the two A and B recommendations by the USPSTF?

A

Bone mass measurement
Colorectal CA screening
Mammograms
Pap/pelvic

31
Q

What fraction of pts with breast CA are 65+?

A

More than half

32
Q

What is the chance of developing breast CA at age 50? At 80?

A

1: 50
1: 8

33
Q

What is the rating given by the USPSTF for breast biennial mammograms?

A

B

34
Q

What is the rating given by the USPSTF for breast self exams?

A

D

35
Q

What is the rating given by the USPSTF for breast biennial mammograms for women over the age of 75?

A

I

36
Q

What is the rating given by the USPSTF for breast MRI screens for breast CA?

A

I

37
Q

What is the age cutoff for biennial mammograms?

A

75 yo

38
Q

What percent of cervical cancers are caused by HPV?

A

93%

39
Q

True or false: older women are less likely to present with advanced cervical CA?

A

True

40
Q

At what age are pap smears not recommended? What is the USPSTF recommendation?

A

65

D

41
Q

Women aged 21-65 would get pap smears how often?

A

Every three years

42
Q

What is the recommendation for cervical CA screening for women 30-65?

A

Combination of cytology and HPV testing

43
Q

Why is COPD associated with osteoporosis?

A

Chronic steroid use may cause osteoporosis

44
Q

What are the major risk factors for osteoporosis?

A
Wt >60 kg
EtOH
Smokes
Family h/o
Caffeine
45
Q

What is the single best indicator of osteoporosis?

A

wt

46
Q

What is the USPSTF recommended of screening for osteoporosis for men and women?

A

B for women 65+

I for men

47
Q

What are the two risk factors for prostate CA?

A

First degree relative

African American

48
Q

True or false: it is not known whether a PSA screen will reduce the risk of death from prostate CA

A

True

49
Q

What are the two diseases that can show elevated PSA?

A

prostatitis or BPH

50
Q

What is the USPSTF recommendation for PSA screening?

A

D

51
Q

What fraction of men with limited life expectancy continue to receive PSA?

A

1/3

52
Q

Does a 65 yo white male need a PSA test?

A

No

53
Q

For every 3000 PSA tests, how many pts get ED or incontinence?

A

120

54
Q

For every 3000 PSA tests, how many pts get CV event?

A

6

55
Q

For every 3000 PSA tests, how many pts get a DVT?

A

3

56
Q

For every 3000 PSA tests, how many pts die?

A

1

57
Q

What percent of colon CAs happen after the age of 50?

A

90%

58
Q

In what population is colon CA high?

A

African American men

59
Q

Colon cancer has an A rating for what age range?

A

from 50 to 75

60
Q

What is the absolute cutoff for colon CA screening?

A

85 yo

61
Q

What are the three other recommendations for screening in pts? (3)

A

Cognitive impairment
Glaucoma screening
TSH in women