Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

SUMGERI > GERI-AGIN > Flashcards

GERI-AGIN Flashcards

1
Q

Why do we have a gray crisis?

A
  • improved life expectancy
  • decrease in birth rates
  • public health improvements (abx, vaccination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What percentage of the population will be over 65yo by 2050?

A

30%! 82.5 million people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the two key theories behind the biology of aging?

A

Genetic Predisposition:
-things are predisposed to go badly for certain people

Wear and Tear: -accumulated pathology, carcinogens, cellular trauma, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the rule of fourths things that impact aging over time?

A

1/4 disease,
disuse (atrophy),
misuse (injury)
physiology (elasticity, density - things don’t hold up over time)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some important characteristics of aging?

A
  • increased mortality with age after maturation
  • biochemical composition of tissues changes
  • physiological capacity decreases
  • decrease in response to environmental stimuli (more likely to hurt themselves because they’re not as sensitive to the outside world)
  • increased vulnerability to disease
  • epigenetic (telomeres, DNA changes over time, etc.)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some important age-related physical changes noted in the slides?

A
  • blood pressure regulation: orthostasis
  • volume regulation: dehydration, over-hydration
  • thermoregulation: colder
  • impaired immune response: increased infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some important age-related sensory changes noted in the slides?

A
  • vision: reduced lens elasticity
  • hearing: increased vestibular sensitivity, reduced acoustic sensitivity
  • taste: reduced
  • smell: reduced
  • touch: reduced reflex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does the heart change with aging?

A

max HR is 195 in adults; reduces to 155 in geriatrics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does the skin change with aging?

A

reduced elasticity - wrinkles!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do the kidneys change with aging?**

A

reduced by 50% perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does the GI tract change with aging?

A

reduced peristalsis/secretions - elderly pts are often constipated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What happens to body composition during aging?

A

% body water = decreased

% body fat = increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What happens to the brain during aging?

A

weight decreases by 7% atrophy

- more brain damage because there’s more space for the brain to move around and hit things during a fall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What happens to sleep patterns during aging?

A

markedly reduced stage 3 and 4 sleep more frequent awakenings, reduced sleep efficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What happens to bone mineral content during aging?

A

diminished by 10-30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What happens to the prostate gland during aging?

A

increases by 100% - can be up to the size of a grapefruit!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What happens to sexual function during aging?

A

men: reduced intensity and persistence of erections; decreased ejaculate and ejaculatory flow
women: menopause; reduced lubrication; vaginal atrophy

18
Q

What does diminished reserve mean?

A

There’s not as much backup reserve and our systems don’t work as efficiently as they did before

19
Q

What are some physiological and clinical examples of diminished reserve?

A

Physiological: -pulmonary capacity
-renal clearance 1/10th of pop: CKD, 8th leading cause of death
Clinical: -increased sleep requirement
-decreased calorie needs (less activity)
-skin alterations that result in decreased protection -nocturia

20
Q

What can we see as far as brain change on CT of a geriatric pt?

A
  • loss of brain parenchyma
  • enlargement of ventricles
  • widened sulci
21
Q

What can we see on imaging of a pt with osteoporosis?

A
  • thinned cortex from inside out
  • scanty trabecular
  • osteophitic changes
  • edges of the bone have a scattered, jagged appearance; they have holes, more bone spurs, etc.
  • their bones are more likely to break
22
Q

What do we see on CXR of someone with CHF?

A
  • interstitial pulmonary edema
  • cardiomegaly
  • redistribution of pulmonary blood to upper lungs -indistinct hilar margins and blurring of pulmonary vessels
  • Kerley B lines at costophrenic angles
  • increased central interstitial markings
  • HF leading cause of death in the US
23
Q

What are some important consequences of aging to note?

A

-atypical presentation of disease
- things do not appear how they do in the textbook! Occam’s Razor - usually the most simple solution is usually the right one but in these pts, we can seldom diagnose one single thing.
Most of their diseases become multifactorial due to comorbidities
-decreased physiological compensation

24
Q

What is the third leading cause of death (2017) in the US?

A

HCP-increased risk of iatrogenic consequences of illness polypharmacy

25
Q

What are some theories behind the prevention of aging?

A

Disengagement: -let go of trappings of earlier life

  • popular driver of retirement communities of the 50s-80s Activity: -stay active and fit to stay young
  • much more prevalent today
  • still less integration in community *probably quite important!
26
Q

What body systems does physical activity impact?

A 
Cardiovascular
Body composition 
Metabolism 
Bone health
 Psychological well-being
27
Q

What is a benefit of continuity with a PCP for elderly pts?

A

much easier to see changes over time

28
Q

What immunizations are recommended for elderly pts?

A

-flu and pneumonia
-herpes zoster
-osteoporosis prevention
-influenza tetanus, diphtheria, pertussis varicella zoster measles, mumps, rubella pneumococcal
hep A/ B (high risk only)

29
Q

When should you screen for breast cancer? When should you stop screening?

A

bienneal mammography 50-74yo

>75 no evidence! *more likely to die of something else

30
Q

When should you screen for colon CA? When should you stop screening?

A

FOBT, sigmoidoscopy or colonoscopy annually 50-75yo not routine 76-85yo;
no screening >85 adematous polyps
90% premalignant for 5-10yrs

31
Q

When should you stop screening for cervical and prostate CA?

A

no screening >65yo exception is if female has never had a pap,
you need to get 2x negative paps and then you can stop screening

32
Q

What are some major flaws in the care of elders?

A

Agism 1. -withholding rx or intervention 2/2 age, lack of respect for cognition
2. Failure to recognize acute change of mental status
continuity vs baseline
3. Poor communication specialist, hospital, LTC

33
Q

What is the main issue with care in elder when sharing information?

A

Failure to utilize critical team members: RX, PT, Nutrition. 2. Dont’ accep MEDICare,medical

34
Q

Is there always a solution to a pts disease?

A

NO! especially not in the population

  • be honest with them about they’re dying
  • *need to consider QOL and do risks vs benefits analyses
35
Q

What are common diseases/side effects that we as providers cause?

A
  • 1/3 of adults >65 have ADE from RX
  • AKI**: most common side effect from drugs
  • reduced surgical outcomes- rare surgery on elderly
36
Q

What is the historical perspective on geriatric medicine?

A

in the US, the Institute of Medicine Report determined that geriatricians would be teachers of other physicians rather than become primary care providers

37
Q

What are some difficulties in geriatric medicine?

A

Demographic Burden: ethnic, cultural and socioeconomic Medical perspective: different; diseases, presentation of diseases, treatment needs, multiple concurrent chronic diseases

38
Q

What are diversity issues to consider from a geriatric medicine perspective?

A

Elder Diversity: -young old versus 85+

  • singles versus couples
  • fit versus disabled
  • independent living versus institutional
  • $ secure versus $ worries
  • cognitively fit versus impaired
39
Q

What are some of the issues with age bias and medicine?

A 
Lack of training:
 to manage multi-problem patient 
-manage psychosocial issues 
-Time Communication issues 
-sensory (diminished hearing, vision and speech) 
-cognitive reliability 
Reimbursement: ~60%
40
Q

What is important to know about TB and the elderly pt?

A
  • COMMON, especially in LTC everyone in a nursing home gets PPD or CXR
  • check for wt loss, fever, night sweats, pneumonia, chest pathology
  • seek hx of prior disease and immune limitations -screening: PPD x2, blood, CXR,

SUMGERI (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions