Geriatric D/O

Question 1

What happens to the lens of the eye as we age

Answer 1

Lens thickens and loses elasticity resulting in cataracts and presbyopia
Thickening of lens and decreasing size of the anterior chamber increases risk for glaucoma
Inclusion bodies in the posterior chambers vitreous creates “floaters.”

Question 2

What happens to the retina of the eye as we age

Answer 2

include a reduction in the number of rods and cones (decline in light and color sensitivity)
Diminished evoked potential responses in the visual cortex in the occipital lobes
Increased risk of macular degeneration, diabetic retinopathy and blindness

Question 3

Age related hearing loss

Answer 3

presbyacusis

Nearly 1/3 of people over 65 and half over 85 have at least a 20% hearing loss.

Question 4

Olfaction and aging?

Answer 4

Decreased olfaction and its relation to taste results in poor nutritional intake
Decreased olfaction results in more elderly victims of home gas leaks

Question 5

What happens to taste as we age?

Answer 5

Decreased taste sensation along with loss of olfaction leads to reduced desire to eat.
Weight loss results

Question 6

What is the most common risk factor for polyneuropathy

Answer 6

DM

Question 7

Parkinson’s Dz is caused by?

Answer 7

Caused by changes in the dopaminergic system

Question 8

Classic Triad of parkison’s

Answer 8

resting tremor, rigidity and bradykinesia

Question 9

Treatment for parkinson’s

Answer 9

carbidopa/levodopa

Side effects can include, akinesia, dyskinesia, sleep disturbances and dementia

Question 10

Epidemiology for stroke?

Answer 10

Stroke is the 3rd leading cause of death in the elderly population
500K have a stroke every year and many who survive are left with significant neurological deficits
The single biggest risk factor for stroke is advancing age

Question 11

Symptoms of TIA

Answer 11

facial weakness, hemiparesis, aphasia if present in anterior circulation, Amaurosis fugax
diplopia, bilateral blindness or blurry vision, unsteady gait, dysarthria or dysdiadochokinesia

Question 12

Hallmark of stroke Tx? (3)

Answer 12

Limit the extent of the stroke
Prevent or reduce risk of secondary complications
Reduce risk of subsequent strokes

Question 13

depression in elderly

Answer 13

Fatigue, H/A, anorexia, weight loss, abdominal or muscular pains can be due to depression.
should be considered in patients that there cannot find a dx

Question 14

4 potential side effects for depression

Answer 14

Postural hypotension
Urinary retention
Cognitive impairment
Cardiac arrhythmias

Question 15

presentation of herpes zoster

Answer 15

2-3 day prodromal of burning, tingling or paresthesia in affected dermatome.
Most common dermatome over thoracic region
Rash develops with severe pain over affected dermatome (does not cross midline).
Vesicular eruption

Question 16

Treatment for herpes zoster?

Answer 16

NSAID’s or narcotic analgesics PRN
Anti-virals – Zovirax etc
Burrows solution
Rash usually resolves in 2 – 3 weeks

Question 17

Complications of herpes zoster?

Answer 17

Post herpetic neuralgia
Superinfection
Meningitis
Ocular involvement with facial zoster
Corneal ulceration
Ramsay Hunt syndrome