Geriatric EM Lecture

Question 1

Decreased max HR
Decreased cardiac output
Decreased ejection fraction
Decreased response to sympathetic stimuli
Increased prevalance of CAD and CHF
Impaired ventricular compliance
Thickening of valves

Answer 1

CV changes in the elderly

Question 2

Decreased lung compliance
Decreased strength and endurance of resp muscles
Increased stiffness of chest wall
Decreased vital capacity + expiratory flow
Decreased mucocilliary clearance
Increased sensitivty to narcotic induced depression
Increased incidence of small airway closure

Answer 2

Pulm changes in eldely

Question 3

Decreased GFR
Decreased renal mass, blood flow + permeability
Decreased ability to concentrate urine, leading to decreased ability to conserve H2O
Dysregulation of Renin-Aldosterone
Impaired Vit D metabolism
Decreased thirst mechanism

Answer 3

Renal changes in elderly

Question 4

Impaired swallowing
Impaired GI mucosal protective mechanisms
Decreased GI motility and absorption
Impaired hepatic drug clearance

Answer 4

GI changes

Question 5

Decreased muscle mass
Decreased bone density

Answer 5

MSK changes

Question 6

Loss of subcutaneous fat layer
Loss of elastic collagen
Loss of glandular function
Skin= frail and thin
Increased benign and malignant skin changes

Answer 6

Integumentary changes

Question 7

Decreased thyroxine
Decreased insulin sensitivity
Impaired Ca and Vitamin D metabolism

Answer 7

Endocrine changes in elderly

Question 8

Changes in T and B cell mediated immunity
Decreased neutrophil activity and fxn

Answer 8

Immune changes in elderly

Question 9

Adverse drug effects lead to __% of all ED visits for patients over 65

Answer 9

11%

Question 10

Memory impairment
Confusion
Hallucinations
Urinary retention
Impaired sweating
Dry mouth
Blurred vision
Constipation
Nausea
Tachycardia
Increased risk of cognitive decline

Answer 10

why you dont give anti-cholinergics to the elderly