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Geriatrics > Exam 2 > Flashcards

Exam 2 Flashcards

Everything except DM

1
Q

Input from the 5 senses; can be ignored or perceived and transferred to short memory in <1 second

A

Sensory memory

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2
Q

Limited capacity
Temporary recall
Processed in 10–15 seconds long-term storage or decay

first to go when there are memory lapses

A

Short-term memory

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3
Q

Subconscious influence of previously encountered information on subsequent performance

*stays the longest

A

Implicit (procedural)

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4
Q

Structured facts, meanings, concepts, and knowledge

A

Explicit– semantic

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5
Q

Autobiographical of events, contextual knowledge, and associated emotions

A

Explicit– episodic

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6
Q

hyperactive, hypoactive, mixed

A

Types of delirium

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7
Q

apathy
loss of interest in activities
social withdrawal
isolation
trouble concentrating
impaired thinking

A

similar features of dementia and depression

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8
Q

dementia is a global impairment impacting intellectual functioning, memory, and at least one of the following

A

Abstract thinking
Judgment and language
Identification of people and objects
Personality changes
Ability to use object appropriately

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9
Q

associated with cerebrovascular disease
memory loss usually less severe than AD
mood changes
can occur in conjunction with AD–> mixed dementia

A

key features of vascular dementia

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10
Q

impaired attention, planning
difficulties with complex activities
disorganized thought

A

symptoms of vascular dementia

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11
Q

complex visual hallucinations
parkinsonism
sleep disturbances
fluctuating cognition

most likely to be misdiagnosed

A

dementia with lewy bodies

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12
Q

Parkinson’s disease dementia (PDD)

Dementia with Lewy bodies (DLB)

Neuropsychiatric symptoms → DLB

A

3 presentations of lewy body disease

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13
Q

common in younger groups
memory intact in early stages
changes in behavior and personality
disinhibition and impulsivity are common

types: Pick’s disease, progressive supranuclear palsy, and corticobasal degeneration

A

frontotemporal dementia

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14
Q

gradual loss of memory and function
eventual inability to recognize friends/ family/ self

majority of cases– 50-60%

A

Alzheimers disease

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15
Q

repair is disabled by amyloid plaques

A

Alzheimer’s disease

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16
Q

aggregation of amyloid beta–>
tau tangle formation–>
inflammation–>
synapse dysfunction and cell death–>
dementia

A

Amyloid Hypothesis

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17
Q

ApoE4 carriers have greater AB deposits than non-carriers

A

4= greatest risk
2= lower risk

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18
Q

donepezil and memantine

A

drug options for neurotransmitter depletion

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19
Q

removes beta amyloid plaques from the brain

A

aducanumab

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20
Q

blocks formation of amyloid beta plaques in the brain

A

lecanemab

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21
Q

temporal lobe and hippocampus

A

memory loss

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22
Q

frontal lobe and limbic system

A

personality/behavior changes

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23
Q

appears normal
stays mentally and physically active
no treatment necessary

A

no impairment

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24
Q

will begin to experience forgetfulness
no treatment necessary

A

very mild decline

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25
Q

will begin to notice a change and decline in function
Alzheimers can be diagnosed

A

mild decline

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26
Q

thinking and reasoning become more obvious and new issues appear
clear s/sx of AD are seen

A

moderate decline

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27
Q

may experience significant confusion and become agitated
begins to require help with day to day activities

A

moderately severe decline

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28
Q

may begin to wander
requires assistance/ reminders with ADLs
requires constant supervision

A

severe decline

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29
Q

loss of ability to respond to environment or communicate
loss of movement and locomotion
disease complication may result in death

A

very severe decline

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30
Q

no cognitive impairment (NCI)

A

0

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31
Q

very mild cognitive impairment (MCI)

A

0.5

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32
Q

mild dementia

A

1

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33
Q

moderate dementia

A

2

34
Q

severe dementia

A

3

35
Q

blessed orientation memory-concentration test
mini cognitive assessment instrument
mini mental state exam
montreal cognitive assessment

A

screenings for cognitive loss

36
Q

pentagon copying test
clock drawing test

A

screenings for perceptual motor function

37
Q

boston naming test
phonemic fluency

A

screenings for language

38
Q

beck cognitive insight scale

A

screening for social cognition

39
Q

trail making test A and B

A

screening for complex attention

40
Q

forward and backward digit span test
trail making test
stroop test

A

screening for executive function

41
Q

beck depression inventory
geriatric depression scale

A

screening for depression

42
Q

____ is a predictor of MCI, highly correlated with functional independence and comorbidity

A

gait speed

43
Q

weight loss
fatigue
low physical activity
slowness
weakness

A

3 out of 5 phenotypic criteria needed for frailty

44
Q

gait speed >1.0-1.2
30sCRT 15 reps or more
independent for floor transfer

A

fit (not frail) characteristics

45
Q

gait speed 0.8-1.2
30sCRT 8-15 reps
modified floor transfer

A

mild frailty (prefrail) characteristics

46
Q

gait speed 0.5-0.8
30sCRT <8reps
assistance for floor transfer

A

moderate frailty characteristics

47
Q

gait speed <0.5
30sCRT unable
floor transfer unable

A

severe frailty (end stage)
hospice candidate

48
Q

more conditions=higher impairment= death
more than 50 items= 100% risk of death in 20 months

A

frailty index

49
Q

gait speed, grip strength, repeated chair rise

A

3 criteria for frailty

50
Q

45 minutes
aerobic– 20
resistance training– 10
balance– 8
flexibility– 7

A

total session treatment for frailty

51
Q

key components for treating frailty

A

reduce biological age
address sarcopenia
12 week programs can show significant gains

52
Q

actions taken before a disease

A

primary prevention

53
Q

focuses on early detection to reduce harm and support early intervention

A

secondary prevention

54
Q

aims to improve quality of life for people who already have the disease

A

tertiary prevention

55
Q

example of primary prevention

A

maintaining proper body weight
sleep
cognitively stimulating activites

56
Q

example of secondary prevention

A

multimodal approach
medication management
falls prevention
nutritional support
exercise program

57
Q

example of tertiary prevention

A

encourage physical activity

58
Q

frailty CPG

A
  1. Suspect frailty in individuals > 75 yr old in any type of setting
  2. Evaluate for frailty using SPPB along with assessing body wt, reducing PA, and fatigue level
  3. Confirm frailty in those with at least 3 of the 5 phenotypes
  4. Provide complete assessment of patient across ICF model
  5. Promote PA and proper diet to increase body weight
  6. Provide monitoring and regular assessments
  7. ID frail older adults in hospital settings, est appropriate DP
  8. Pt info should be available throughout healthcare database
59
Q

decreased bone mass and density

A

osteoporosis

60
Q

low bone density that compromises the bones ability to absorb loads

A

osteopenia

61
Q

t score < -2.5

A

osteoporosis

62
Q

t score -1 to -2.5

A

osteopenia

63
Q

vitamin D and calcium
fluoride
Bisphosphonates
calcitonin
regular WB activities
surgery to reduce kyphosis

A

treatment of osteoporosis

64
Q

standing/ WB exercises
strengthening, flexibility, balance activities

A

what builds bone/strength

65
Q

what should be avoided with osteoporosis

A

trunk flexion and excessive rotation
high impact exercises
joint mobs/ manual percussion

66
Q

neighborhood and built environment
economics
health and healthcare
education
social and community contexts

A

5 social determinants of health

67
Q

identify problem
conduct research and gather data
establish principles, priorities/outcomes
develop and implement an advocacy plan
build/support/ manage opposition
assess and evalute

A

advocacy process

68
Q

whats covered with HH

A

skilled nursing care
PT OT SLP
social services
injectable osteoporosis drugs
DME
medical supplies

69
Q

whats not covered with HH

A

24 hour care
meals delivered to the home
homemaker services
personal care with ADLs

70
Q

criteria 1 for medicare A benefits

A

“the patient must either, because of an injury or illness, need the aid of support devices (such as crutches, canes, wheelchairs and walkers; the use of special transportation; or the assistance of another person to leave the home)”

“OR have a condition that leaving the home is medically contraindicated.”

71
Q

criteria 2 for medicare A benefits

A

“there must exist a normal inability to leave home

“AND leaving the home must require a considerable and taxing effort.”

72
Q

home setting is ideal for ____ based PT

A

function

73
Q

outcome and assessment information set (OASIS)

A

assesses if patient meets HH coverage criteria
PT is one of 3 disciplines that complete this for an initial evaluation

74
Q

areas of assessment in HH

A

medication reconciliation
fall risk screening
home safety assessment
functional assessment testing
emergency situations
personal safety

75
Q

medicare A

A

60 day certificate for patients admitted for HH services

76
Q

medicare covers skilled maintenance programs when

A

the therapy procedures required to maintain the patient’s current function or to prevent or slow further deterioration

OR

the particular patient’s special medical complications require the skills of a qualified therapist to furnish a therapy service required to maintain the patient’s current function or to prevent or slow further deterioration

77
Q

home health challenges

A

safety and security
living conditions (environment, support, elder abuse)

78
Q

home evaluation 3 part assessment

A
  1. inside and outside the home
  2. observe person moving around the environment
  3. determine fall risk
79
Q

cost of caregiving

A

financial
social
emotional
physical

80
Q

caregiver relationships

A

spousal/partner
parental
dementia

81
Q

burnout syndrome

A

emotional exhaustion
depersonalization
reduction in personal fulfillment

Geriatrics (2 decks)

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