Geriatric Flashcards
Longitivity depends more on
Genetic or environment
Environment (50%)
Loss of complexity in elderly indicate
Reduced 1- HR 2- BP 3- EEG 4- Auditory frequency 5- Response to stress
What are the hematopoietic changes in aging?
Reduced:
1- bone marrow reserve > Myelotoxicity w\chemo.
2- WBC function > increased infection
Increased:
3- Platelet responsiveness > increased blood clotting
What are the hepatobiliary\renal changes in aging?
- LFT reduced
(Low blood flow + decreased liver mass) - RFT reduced
(Low creatinine clearance)
What are the CVD changes in aging?
1- Maximum HR
2- Ejection fraction after exercise
3- Valvular sclerosis
What are the respiratory changes in aging?
1- Reduced PO2
2- Increased alveolar-arterial gradient (hypoxia at high altitude)
3- Reduced FVC
4- Reduced Peak aerobic capacity.
What are the Genitourinary changes in aging?
1- UTI + incontinece (due to estrogen withdrawal)
2- erectile dysfunction + dyspareunia
3- decreased detrusor muscle + increased post-void residual.
What are the musculoskeletal changes in aging?
1- Decrease muscle mass in legs
2- Myosteatosis (fat infiltration into muscles)
3- decreased strength
What are the Skin changes in aging?
Decreased elasticity + Photo-aging.
What are the Eye changes in aging?
1- Eyelid relaxing
2- decreased tearing + increased watering w\drainage
What are the auditory changes in aging?
1- decreased high frequency acuity
When to screen for: BP
Annually
When to screen for: Weight
Annually
When to screen for:
Hearing
Annually with patient inquiry
When to screen for:
Vision
Not indicated
When to screen for:
AAA
Men 65-75 + Smoking history.
How to screen for cognitive impairment, mood and gait in patient >65 years.
- Cognitive: Mini mental state
- Mood: PHQ2 in last month
- Gait: get up and go test
When to screen for:
DM
- USPSTF: 40-70 + overweight.
- ADA: all >45 OR <45 + overweight + 1 risk factor.
When to give:
Tetanus Vaccine
- Every 10 years (start Tdap >Td)
- After 50. (Previously completed series)
When to give:
Influenza Vaccine
Annually
When to give:
Pneumococcal Vaccine
- Unvaccinated: 13 — 6\12m — 23
- Vaccinated before 65: 23 — >1y — 13 — 6\12m — 23
- Vaccinated after 65: 23 — >1y — 13
When to give:
Herpez zoster Vaccine
(2 dose w\6 m interval)
- > 50: Shingrex
- > 60: Shingrex or Zostavax
When to screen for:
osteoprosis
- Female: > 65 - <65 if high risk
- Male: not enough evidence.
When to screen for:
Breast cancer
- 40 to 49: based on preference or hx.
- >50: Mammo every 2 years
How to diagnose osteoporosis:
By DEXA
(
Differentiate between primary and secondary osteoprosis?
.
labs done in secondary osteoprosis:
.
What are the potentially modifiable risk factors for osteoporosis:
.
In osteoporosis with kidney failure, the treatment of choice is:
.
In osteoporosis with Cancer, the treatment of choice is:
.
First line treatment for osteoporosis:
.
Why to stop osteoprosis treatment in women after 5 years:
.
Vertebral fractures in mens are prevented by:
.
What is the role of estrogen therapy in women with osteoporosis
.
What are the side effects of bisphosphonate:
.
DXA intervals for the following osteopenia patients:
- 2-2.49
- 1.5-1.99
- > 1.5
.
Before starting bisphophanate therapy, what test do you use to do? And what are the results?
.
Definition of FRAX?
.
