Elderly Illnesses-Shumaker

Question 1

What are the leading causes of death for 65+ age group?

Answer 1

1. heart dx
2. cancer
3. chronic lower resp
4. stroke
5. alzheimer’s

Question 2

What are common causes of morbidity over age 65? Not mortality.

Answer 2

Osteoarthritis
Hypertension
Heart disease
Hearing impairment
Vision impairment
Dental needs
Cognitive impairment (40% over 85 have a major neurocognitive disorder)
Functional impairment

Question 3

What are some critical things for the elderly that are not covered by medicare?

Answer 3

eye glasses
hearing aids
dentures

Question 4

How do you pay for long-term nursing home stays?

Answer 4

medicaid

private payer

Question 5

How do you pay for long-term nursing home stays?

Answer 5

medicaid
private payer
at least $60K/yr

Question 6

T/F Elderly have cookie cutter presentations of illness, steady homeostasis, and plentiful functional reserve.

Answer 6

False.

Atypical presentations of acute illness
Altered homeostasis
Decreased functional reserve

Question 7

T/F Function & cognition is the main focus of the aging pop. rather than just the medical problem list.

Answer 7

T

Question 8

T/F Readmission w/i 30 days are not reimbursed.

Answer 8

T

Question 9

What is the most common discharge diagnosis for patients over the age of 75?

Answer 9

congestive heart failure

Question 10

What are the aging changes for the musculoskeletal system?

Answer 10

decreased muscle and bone mass; height loss; osteoarthrosis of heavily used joints. Pain and deconditioning are common

Question 11

What are the aging changes for cardiovascular system?

Answer 11

arteriosclerosis, increased collagen cross-linking, impaired baroreceptor function

Question 12

What are the aging changes for the pulmonary system?

Answer 12

decreased lung vital capacity and cough reflex, increased residual volume, impaired mucociliary clearance. Swallow dysfunction can occur and aspiration is fairly common.

Question 13

What are the aging changes for the GI system?

Answer 13

decreased gastric acid but normal absorption. Dry mouth, dental loss. Constipation is common

Question 14

Common musculoskeletal diseases in the elderly?

Answer 14

osteoarthritis, DDD, osteoporosis, hip fracture

Question 15

Common cardiovascular diseases in elderly?

Answer 15

hypertension (especially systolic), coronary artery disease, heart failure with preserved EF (diastolic dysfunction), systolic heart failure, atrial fibrillation, aortic stenosis, peripheral vascular disease

Question 16

Common pulmonary geriatric diseases?

Answer 16

Deconditioning with exertional dyspnea, COPD esp. in smokers or prior smokers, pneumonia, aspiration pneumonitis and pneumonia

Question 17

Common GI diseases of geriatric population?

Answer 17

– Decreased appetite, weight loss – variety of causes. GERD, constipation, cancers, diverticulosis/ itis.

Question 18

Common cause of pneumonitis in elderly? Treatment?

Answer 18

aspiration causes inflammation of lungs
just monitor, will clear in several days
unless vitals are in jeopardy

Question 19

Common aging changes for genitourinary system?

Answer 19

Decreased bladder capacity but increased residual after voiding
Males – prostate enlargement, voiding problems, impotence
Females – atrophic vaginitis, stress and urge incontinence, bacterial colonization of bladder

Question 20

Changes in immunologic system of elderly?

Answer 20

Impaired cell mediated immunity (CMI) (- increased rates of cancer, lymphoma, H. zoster (shingles), even reactivation of latent tuberculosis)
Impaired skin, mucous membrane and respiratory tract barrier functions
(increased rates of infection of lung, urinary tract and skin - pneumonias, UTIs, cellulitis.)

Question 21

Causes for weight loss in elderly?

Answer 21

medications
decreased appetite
cancer
decreased access to grocery store
depression
dental pain, lack of teeth etc.

Question 22

Changes in neurology/special senses in elderly?

Answer 22

Memory loss complaints are common.
Mild Cognitive Impairment can progress to dementia
Presbyacusis, presbyopia, lens opacification – difficulty with low lighting, glare, contrast.
Diminished sense of smell may be an early marker for dementia! Can affect taste, nutrition.

Question 23

T/F Dementia is normal aging.

Answer 23

False.

Question 24

Different types of incontinence?

Answer 24

stress
urge
overflow
functional (can’t remember to use bathroom)

Question 25

What are some common neuropsych issues?

Answer 25

anxiety
sleep disorder
atypical depression

Question 26

T/FYou can encode and process faster as an elderly person, but lose your knowledge base, such as vocab.

Answer 26

False.
slower processing & learning
solid knowledge base.

Question 27

Multiple actinic keratoses on the sun-exposed scalp put you at increased risk for what?

Answer 27

squamous cell carcinoma on forehead

Question 28

What is a common neoplasm to find on the helix of the ear of an elderly person?

Answer 28

basal cell carcinoma

Question 29

When is the shingles vaccine recommended?

Answer 29

at age 60

Question 30

What is the most common type of hearing loss in the elderly?

Answer 30

high frequency hearing loss

need to have a low voice.

Question 31

What is the most common eye deficit w/ aging?

Answer 31

presbyopia–inability to focus on nearby objects.

Question 32

Common neuropsychological, cognitive diseases in elderly?

Answer 32

Mild cognitive impairment
Dementias (now called major neurocognitive disorders) – Alzheimers disease, vascular dementia, mixed dementia, Lewy body disease, frontotemporal dementia etc.
Medical delirium (altered mental status, acute confusional state)
Stroke, TIA
Parkinsons disease
Neuropathies, myopathies –diabetic, degenerative, medication, etc.
Sensorineural hearing loss, cataracts, macular degeneration
Anxiety and depressive disorders

Question 33

What is a weird presentation of acute MI in elderly?

Answer 33

confusion
SOB
weakness, fatigue
falls
neurological signs

Question 34

T/F Pneumonia in the elderly may present w/o cough or fever.

Answer 34

T

Question 35

How might hyperthyroidism present in an elderly patient?

Answer 35

afib
heart failure
SOB