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(OMS2) OS III Final > Final: OAT Geriatric Patient > Flashcards

Final: OAT Geriatric Patient Flashcards

1
Q

What are the subgroups for old?

A

Young old: 65-75
Older-old: 75-85
Old-Old: 85+

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2
Q

What is important to consider in elderly patient treatment?

A
  1. Decreased healing
  2. Increase risk of side effects
  3. Patient centered care**
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3
Q

What are the goals for geriatric treatment?

A

Optimize function
Avoid Hospitalization
Maintain Community Involvement

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4
Q

How do arteries change as we age? How does this complicate things?

A

More calcification, decreased elasticity and loss of baroreceptor reflex makes treatment harder and increases risk of hypotension and falls

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5
Q

If a patient is older than 60, what are the BP goals?

A

SBP <150mmHg

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6
Q

If a patient is older than 60 with a history of TIA or CV risk, what is BP goals?

A

SBP <140mmHg

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7
Q

What are the two most common causes of HF?

A

HTN and CAD

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8
Q

Fatigue, DOE, and sleeping propped up in a chair are signs and symptoms of?

A

Heart failure

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9
Q

When treating an elderly patient for HTN, what is important to watch for?

A

Orthostatic Hypotension

-falls!

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10
Q

If systolic BP drops more than 20mmHg, or diastolic more than 10mmHg after pt stands, what is diagnosis?

A

Orthostatic Hypotension

-fall risk=hip fractures

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11
Q

As we age, how does immune function change?

A

Immune system decreases

  • loss of T cell fxn, decreased renal mass
  • -increase infections (especially if catheters!)
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12
Q

As we age, how does metabolic function change?

A

Relative altered glucose metabolism

  • relative resistance to insulin/islet cell dysfunction
  • -altered muscle mass, functional disability, frailty
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13
Q

How does fever change in frail, older adults?

A

> 37.8 in single temp
or
1.1 C increase from baseline

In healthy adults its just >38 C (100.4 F)

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14
Q

As you age, do you have more or less chance for adverse drug reactions?

A

More

-renal/hepatic function declines means you clear less

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15
Q

What is considered pre-diabetes, diabetes, and uncontrolled diabetes on A1C?

A

Pre: 5.7-6.4%
Diabetes: >6.5%
Uncontrolled: >8%

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16
Q

What are the geriatric goals for A1C? For healthy, complex and poor health

A

Healthy: <7.5%
Complex: <8.0%
Poor: <8.5%

17
Q

A T-score on a DEXA scan less than -2.5 means what?

A

Osteoporosis

18
Q

How can you prevent osteoporosis?

A

Regular weight Bearing exercise

Ca++ and Vit D supplementation

19
Q

What is the cause of the leading risk of injury among elderly?

A

Falls

  • less proprioception
  • less muscle mass
  • less stability
20
Q

After one fall, is a patient more or less likely to have another fall?

A

More

-just a vicious cycle

21
Q

The Get up and Go test for your patient times out to 13s. What does this mean?

A

It took your patient too long=fall risk

-they stood up, walked three steps forward, walked three back and sat down

22
Q

If an older patient has a fall, and their leg swollen, painful, there is significant bruising and the leg is shortened and externally rotated what does that mean?

A

Intertrochanteric fracture

23
Q

How do you diagnose intertrochanteric fx?

A

AP and Lateral veiw comparison between bad and good leg

24
Q

As we age, what happens to our neurologic system?

A

Decreased brain weight
Decreased vibratory sense
Alteration in CNS NTs
Increased postural instability

All leads to more dementia and fall risk

25
Q

If a patient has onset of delerium, you should think what two causes?

A

Infection: UTI, pneumonia, influenza
Meds: H1 blocker or anticholinergics

26
Q

What are the levels for the mini mental exam? Mild, moderate, severe

A

Mild: 21-29
Moderate: 10-10
Severe: <9

27
Q

Diagnose the patient: 65 yo male with symptoms of low back pain usually walks 3-5 miles a day but now has symptoms of leg fatigue and simply cannot make it that far. Their pain is relieved in flexion and worse on extension. Dx?

A

Spinal stenosis

  • remember spondylysis/spondylistesis
  • -L4/L5 is most common location
28
Q

If a patient has moderate/severe symptoms of spinal stenosis, what is best way to treat?

A

Surgery>conservative tx

Injection
OMT for those who do not want surgery

29
Q

OMT considerations for Spinal Stenosis?

A

Normalize Autonomics

  • Psym: Sacrum
  • LE: T12-L2

indirect techniques (CS, FPR, BLT, MFR)

30
Q

Increase in somatic complaints, cognitive changes, sleep problems, fatigue, and low energy are all signs of what?

A

Atypical presentation of geriatric depression

31
Q

First line meds for depression?

A

SSRIs

32
Q

What is the score on the geriatric depression scale (out of 15) that represents probably depression?

A

> 5/15

(OMS2) OS III Final (7 decks)

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