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Geriatrics > Final > Flashcards

Final Flashcards

1
Q

What % of Americans will be over the age of 65 by 2030?

A

22% (70.2M)

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2
Q

What is the average age of life expectancy in women (US)?

A

79.5 years

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3
Q

What is the average age of life expectancy in men (US)?

A

72.7 years

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4
Q

5 Theories of Aging

A 
Cellular "supply limits" theory
Free radical damage theory
Autoimmune theory
Programmable cell death theory
Telomere length theory
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5
Q

What % of cancers have a p53 mutation?

A

50%

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6
Q

What is a telomere?

A

Non-coding DNA at the end of each chromosome, which assist in a limited number of cell divisions

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7
Q

How can the finite activity of telomeres be altered?

A

The enzyme telomerase, present in embryonic stem cells and cancer cells, allows for unlimited cell growth.

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8
Q

What are the effects of H2 blockers and PPIs in patient on long-term NSAIDs?

A

H2 blockers accelerate ulcer formation.

PPIs decelerate ulcer formation.

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9
Q

Long-term PPI use is linked to what skeletal deformity?

A

hip fractures

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10
Q

What condition can be caused by Metformin that was previously not thought possible?

A

lactic acidosis

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11
Q

SSRIs - associated deficiencies

A

B6, B12, folic acid

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12
Q

PPIs/H2 blockers - associated deficiencies

A

B12, Ca, Fe, Mg

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13
Q

Metformin - associated deficiencies

A

B12

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14
Q

OCPs - associated deficiencies

A

B5, B6, B12

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15
Q

Seizure medications - associated deficiencies

A

folic acid

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16
Q

Age - Effect on lean body mass, water, and body fat

A

Dec. body mass, Dec. water

Inc. body fat

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17
Q

Fosomax is associated with what adverse skeletal change?

A

Decreased bone mass in facial bones, esp. mandible

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18
Q

Subcutaneous deposition of fat underneath the eyes leads to ____ in the elderly?

A

enophthalmos

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19
Q

Presbyopia

A

age-related farsigthedness

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20
Q

Changes to eyesight in the elderly

A

Impaired accommodation, decreased night vision, decreased tear production, presbyopia, arcus senilis

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21
Q

Arcus senilis

A

benign pigment accumulation

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22
Q

Glaucoma - Central or Peripheral deficit loss?

A

Peripheral

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23
Q

Macular degeneration - Central or Peripheral deficit loss?

A

Central

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24
Q

Cataracts - Central or Peripheral deficit loss?

A

Central

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25
Q

Population: Glaucoma

A

Rare under 40 yo
1% of population 40-60 yo
5% >65 yo

26
Q

At what age is there a shift from increasing bone mass to loss of bone?

A

40

27
Q

1 in __ Americans have arthritis.

A

7

28
Q

Pattern: OA vs. RA

A

OA affects DIPs and PIPs

RA spares DIPs

29
Q

Morning stiffness: OA vs. RA

A

OA - 30 min

30
Q

Exostosis

A

formation of new bone on the surface of existing bone, often leading to chronic pain

31
Q

What lifestyle change is important for stroke prevention, esp. in F?

A

Smoking cessation

32
Q

What was the goal of the Framingham Study?

A

Evaluate relationship between lowering BP and incidence of MI/stroke

33
Q

Which drug class requires a PARQ about the high potential for inducing orthostatic hypotension upon rising?

A

Alpha agonists

34
Q

If orthostatic changes are apparent, always ___

A

check BP in standing position

35
Q

In what populations should you use caution with diuretics and beta blockers?

A

Diabetics –> blunts glycemic response
COPD –> worsens COPD
AFAM

36
Q

The magnitude of the benefit of antihypertensive drugs is proportional to the reduction in ___

A

Systolic BP

37
Q

What is the first-line drug of choice in treating elderly patients who present with isolated systolic HTN?

A

Calcium channel blocker

38
Q

What is the main side effect of CCBs?

A

LE edema

39
Q

What is the most population CCB?

A

Amlodipine (Norvasc)

40
Q

What is the MC cause of acute onset incontinence?

A

UTI

41
Q

What are the 4 main causes of acute urinary incontinence?

A

Delirium
Restricted mobility
Infection, inflammation, impaction
Pharmaceuticals

42
Q

What is the main difference between delirium and dementia?

A

Delirium is reversible

43
Q

What common drug class most commonly causes incontinence?

A

diuretics

44
Q

When is acute onset of incontinence a medical emergency?

A

Pt w/ a known or suspected malignancy

45
Q

In a pt with acute urinary incontinence, acute/sub-acute dementia, and wide-based gait, think ___.

A

Normal pressure hydrocephalus

46
Q

4 types of incontinence

A

Stress
Overflow
Urge
Functional

47
Q

Which type of incontinence is also described as “spastic bladder”?

A

Urge

48
Q

What is the MC type of chronic incontinence in the geriatric population?

A

Urge

49
Q

What conditions can lead to urge incontinence d/t their effect on nerves/muscles?

A

MS, Parkinson’s, Alzheimer’s, stroke, local injury (surgery)

50
Q

What conditions can lead to urge incontinence d/t their irritative effect to the bladder wall?

A

Cystitis
Bladder stones
Bladder carcinoma
Constipation

51
Q

What type of drugs can lead to atonic bladder and overflow incontinence?

A

narcotics, anticholinergics

52
Q

What conditions can lead to overflow incontinence?

A

B12 deficiency, disk compression, diabetes, BPH, urethral fibrosis

53
Q

What are common triggers for stress incontinence?

A

coughing, sneezing, laughing, bending over

54
Q

What is the initial lab evaluation for all patients with incontinence?

A

urine analysis

55
Q

In a pt who presents with hematuria after starting anti-coagulation tx, think ___.

A

possible malignancy in the GU tract

56
Q

What is a good suggestion for all pts with incontinence?

A

Kegel exercises

57
Q

What are the MC cause of injury-related morbidity in the elderly?

A

Falls

58
Q

What is the MC major injury sustained during falls?

A

Hip fracture

59
Q

Physiologically, deterioration of ___ significantly contributes to falls in the elderly.

A

Cervical mechanoreceptors

60
Q

The risk of falling increases with increased ___

A

of comorbidities

61
Q

Contraindication: anticholinergic drugs for urge incontinence

A

Untreated angle closure glaucoma

Geriatrics (1 decks)

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