Final

Question 1

average life expectancy for women in US

Answer 1

79.5 years

Question 2

average life expectancy for men in US

Answer 2

72.7 (7 years less)

Question 3

Theories on why we age

Answer 3

• -The cellular “supply limits” theory
• -The free radical damage theory
• -The autoimmune theory
• -The programmable cell death theory
• -The telomere length theory

Question 4

what do cell signals do to apoptosis

Answer 4

These signals either induce or suppress apoptosis. In this context, the binding and subsequent initiation of apoptosis is termed positive, whereas the active repression of apoptosis by is termed negative.

Question 5

what happens to telomere’s with cell division

Answer 5

process of cell division permanently destroys a tiny fragment of the telomere with each division.

Question 6

Can we add telomerase or drugs that mimic the effects of telomerase to a cell culture to length telomeres?

Answer 6

Yes, but disappointing results so far

Question 7

link that connects most conditions

Answer 7

inflammation aka imflammaging

Question 8

Miller/Chamby personal take on health internet sites

Answer 8

spend as little time as possible on any site where the product being discussed is also being sold.

Question 9

what leads to shortened stature with age

Answer 9

Kyphosis is increased, especially in females. There is a slight bending (flexion) at the knees and hips which leads to a shortened stature.

Question 10

before which age is chronic glaucoma uncommon

Answer 10

uncommon before age 40

Question 11

% of population affected by chronic glaucoma aged 40-65

Answer 11

1%

Question 12

% of population affected by chronic glaucoma aged 65 and over

Answer 12

5%

Question 13

Which diseases of the eye cause central vision loss

Answer 13

Age-Related Macular Degeneration (AMD)
Diabetic Retinopathy.
Macular Edema.
Macular Hole.
Macular Pucker

Question 14

how can you speak to patient’s hard of hearing

Answer 14

It may benefit you to speak in a lower pitched voice to your patients who are hard of hearing rather than speaking more loudly.

Question 15

what is an exostosis

Answer 15

An exostosis (plural: exostoses) is the formation of new bone on the surface of a bone. Exostoses can cause chronic pain ranging from mild to debilitating, depending on the shape, size, and location of the lesion.

Question 16

what is secondary osteoporosis

Answer 16

Secondary osteoporosis implies that the decreased bone mass is due to other conditions, medications, malabsorption, or prolonged immobilization.

Question 17

additional condition which cause increased risk for osteoporosis

Answer 17

Hyperthyroidism
Excess supplemental thyroid
Cushing’s disease
Glucocorticoid use
Hyperparathyroidism

Question 18

what is T-score

Answer 18

T score is the number of standard deviations above or below the mean for a healthy 30 yo adult of the same sex and ethnicity as the patient.

Question 19

what is Z-score

Answer 19

Z score is the number of standard deviations above or below the mean for the patient’s current age, sex, and ethnicity.

Question 20

T-score values

Answer 20

Normal : T-score greater than –1
Osteopenia: T-score between –1 and –2.5
Osteoporosis: T-score below –2.5

Question 21

Prophylactic treatment for osteoporosis is generally begun in a patient with a DEXA scan that reveals:

Answer 21

T-score less then -2.0.

T-score less then -1.5 in a patient with known risk factors for osteoporosis.

Question 22

what is FRAX?

Answer 22

• -FRAX is a diagnostic tool used to evaluate 10 year probability of bone fracture risk.
• -FRAX integrates clinical risk factors with bone mineral density at the femoral neck to calculate the 10-year probability of hip fracture as well as spine, shoulder and extremity fracture.

Question 23

The following conditions are extremely common in the geriatric population:

Answer 23

Hypertension
      ► Urinary incontinence 
      ► Falls
      ► Osteoporosis
      ► Dementia

Question 24

If orthostatic changes are apparent, always check

Answer 24

that patient’s BP in the standing position, whenever possible.

Question 25

initial HTN treatment for elderly

Answer 25

In most instances, low-dose diuretic therapy should be used as initial antihypertensive therapy in the elderly.

Question 26

first line drug of choice in treating elderly patients who present with isolated systolic hypertension.

Answer 26

When drug therapy is indicated, a long-acting calcium channel blocker is now considered as a first line drug of choice in treating elderly patients who present with isolated systolic hypertension.

Question 27

is incontinence normal with aging?

Answer 27

no

Question 28

The main causes of acute urinary incontinence are:

Answer 28

Delirium
Restricted mobility
Infection, inflammation or impaction
Pharmaceuticals

Question 29

most common cause of acute urinary incontinence

Answer 29

Bladder infection is the most common cause of acute urinary incontinence.

Question 30

most common drug to cause incontinence

Answer 30

Diuretics are the most common drug class noted to cause incontinence.

Question 31

incontinence that is a medical emergency

Answer 31

Acute onset of incontinence in a patient with a known or suspected malignancy is a medical emergency.

Question 32

In a patient with the triad of acute urinary incontinence, acute or sub-acute dementia and wide based gait – think

Answer 32

normal pressure hydrocephalus (NPH).

Question 33

most common form of incontinence in elderly

Answer 33

Urge incontinence is the most common form of chronic incontinence in the geriatric population.

Irritation to the bladder wall can also result in urge incontinence.

Question 34

initial lab for incontinence

Answer 34

UA

Question 35

exercise for all incontinence

Answer 35

Kegel exercises should be practiced for all causes of incontinence.

10 repetitions constitute a set – consider a regimen of 3 to 5 sets a day.

Question 36

chronic disability increases the risk of

Answer 36

falling

Question 37

which diseases cause peripheral vision loss?

Answer 37

Glaucoma.
Retinitis pigmentosa.
Eye strokes or occlusions.
Detached retina.
Brain damage from stroke, disease or injury.
Neurological damage such as from optic neuritis.
Compressed optic nerve head (papilledema)
Concussions (head injuries)*