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Emergency Medical Technician > Geriatric Emergencies > Flashcards

Geriatric Emergencies Flashcards

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Royal College: Emergency Medicine flashcards USMLE® Step 1 flashcards
1
Q

The assessment and treatment of disease in someone who is 65 years or older

A

Geriatrics

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2
Q

Older patients will have less help from ___ when they have trouble breathing

A

Muscles in the chest wall

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3
Q

As they get older, the alveoli can become ___

A

Enlarged and the elasticity decreases

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4
Q

Effect of enlarged alveoli with less elasticity

A

Harder to expel air (air trapping)

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5
Q

Monitor changes in oxygen and carbon dioxide levels in the blood

A

Chemoreceptors

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6
Q

As the chemoreceptors become less sensitive with age, the body responds more slowly to ___

A

Hypoxia

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7
Q

Mechanisms lost with aging that protect the upper airway

A
  1. Decreased cough
  2. Gag reflexes
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8
Q

What change in the lungs makes it harder to cough and clear secretions

A

Decrease in the cilia that line the bronchial tree

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9
Q

Inflammation of the lung from bacterial, viral, or fungal causes

A

Pneumonia

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10
Q

Sudden blockage of the artery in the lung by a venous clot

A

Pulmonary embolsim

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11
Q

Disease that causes the arteries to thicken, harden, and calcify

A

Arteriosclerosis

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12
Q

Compliance of the vascular walls depends on the production of ___

A

Collagen and elastin

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13
Q

Collagen and elastin are ___

A

Primary components of muscle na dconnective tissue

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14
Q

An increase in pressure leads to over production of ___ and decreased quantities of ___

A
  1. Collagen
  2. Elastin
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15
Q

Result of arterial stiffening

A
  1. Widening pulse pressure
  2. Decreased coronary artery perfusion
  3. Changes in cardiac ejection efficiency
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16
Q

Accumulation of fat and cholesterol in the arteries

A

Atherosclerosis

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17
Q

Abnormal, blood-filled dilation of the wall of a blood vessel

A

Aneurysm

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18
Q

The stiffening of the blood vessels leads to a ___ systolic BP

A

Higher

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19
Q

At age 75, the number of cells in the SA node will ___

A

Decrease by 90%

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20
Q

You may see a systolic BP drop of ___ when an older person stands up

A

20 mm Hg

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21
Q

Loss of proper function of the veins in the legs that would normally carry blood back to the heart

A

Venous stasis

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22
Q

Blood clots in the superficial veins

A

Superficial phlebitis

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23
Q

Blood clots in the deep veins

A

Deep venous thrombosis

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24
Q

Venous stasis can lead to ___

A

Superficial phlebitis and deep venous thrombosis

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25
Q

Venous stasis usually exhibits with ___

A

Edema of the legs and ankles

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26
Q

Symptoms of MCI in the elderly (especially women and those with diabetes)

A
  1. Dyspnea
  2. Epigastric and abdominal pain
  3. Loss of bladder and bowel control
  4. Nausea and vomiting
  5. Weakness
  6. Dizziness
  7. Lightheadedness
  8. Syncope
  9. Fatigue
  10. Confusion
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27
Q

Fluid in the abdomen

A

Ascites

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28
Q

With right-side heart failure, an enlarged liver may be present from ___

A

Blood backing up through the portal vein

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29
Q

Right-side heart failure is often caused by ___

A

Left-side heart failure

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30
Q

With right-side heart failure, fluid backs up into the ___

A

Body

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31
Q

With left-side heart failure, fluid backs up into the ___

A

Lungs

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32
Q

The excess fluid in the lungs causes ___

A

Pulmonary edema

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33
Q

Condition characterized by sudden respiratory distress that awakens the person at night when the patient is in a reclining position

A

Paroxysmal nocturnal dyspnea

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34
Q

Not being able to breath while lying down

A

Orthopnea

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35
Q

The brain decreases in ___ with aging, and can lose up to ___ of the neurons

A

5% to 50%

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36
Q

Clouding of the lenses or their surrounding membranes

A

Cataracts

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37
Q

Central portion of the retina

A

Macula

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38
Q

Macular degeneration causes ___

A

Vision loss in the central part of the vision field

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39
Q

In retinal detachment, the retina is pulled away from the ___

A

Choroid

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40
Q

Thin layer of blood vessels that supply nutrients and oxygen to the retina

A

Choroid

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41
Q

Retinal detachment may be reported with ___

A

Floaters, debris in the visual field, sudden flashes of light or shadow, or visual blurring

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42
Q

Age-related hearing loss

A

Presbycusis

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43
Q

Gradual onset of progressive disorientation, shortened attention span, and loss of cognitive function

A

Dementia

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44
Q

Dementia is the result of ___

A

Many neurologic diseases

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45
Q

A sudden change in mental status, consciousness, or cognitive processes, and is marked by the inability to focus, think logically, and maintain attention

A

Delirium

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46
Q

Assess a delirium patient for ___ that can be managed at a prehospital level

A
  1. Hypoxia
  2. Hypovolemia
  3. Hypoglycemia
  4. Hypothermia
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47
Q

Dilated pupils may suggest ___ from hypoxia. Earlier hypoxia can lead to ___

A
  1. Brain damage
  2. Pupil constriction
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48
Q

Disorder of the nerves of the peripheral nervous system in which function and structure of the peripheral motor, sensory, and autonomic neurons are impaired

A

Neuropathy

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49
Q

The ability of the liver to ___ declines as a person ages

A

Detoxify and remove drugs from the bloodstream

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50
Q

Why are older people more prone to regurgitation and heartburn or acid reflux?

A

Poor muscle tone of the smooth muscle sphincter between the esophagus and the stomach

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51
Q

Why are older people more prone to constipation?

A

Decrease in hydrochloric acid in the stomach and alterations in absorption of nutrients and slowing peristalsis

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52
Q

Motion that moves feces through the colon

A

Peristalsis

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53
Q

Why are older people more prone to incontinence?

A

Rectal sphincter becomes weak

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54
Q

The liver shrinks, blood flow decreases, and metabolism decreases, leading to ___

A

Changes in how medications are absorbed and affect the patient

55
Q

Condition in which the walls of the gut weaken and small pouches protrude from the colon along those weakened segments

A

Diverticulosis

56
Q

When inflammation usually associated with infection develops in one of the pouches formed from diverticulosis

A

Diverticulitis

57
Q

Diverticulitis usually presents with ___

A

LLQ pain and fever

58
Q

Bleeding that travels through the lower digestive tract usually manifests as ___

A

Melena

59
Q

Red blood usually means a ___

A

Local source of bleeding (hemorrhoids)

60
Q

Upper GI bleeding occurs in the ___

A

Esophagus, stomach, or duodenum

61
Q

Upper GI bleeding is sometimes seen in people who are ___

A

Long-term users of NSAIDs or who are long-term alcohol users

62
Q

Irritation of the lining of the stomach or ulcers can cause forceful vomiting that ___

A

Tears the esophagus

63
Q

Lower GI bleeding occurs in the ___

A

Colon or rectum

64
Q

Lower GI bleeding can be serious, especially in cases where the patient presents with ___

A

Tachycardia and hypotension

65
Q

Peptic ulcer disease is more common in older people, especially those who use ___

A

NSAIDs

66
Q

A patient with peptic ulcer disease will report ___

A

A gnawing, burning pain in the upper abdomen that improves after eating but returns later

67
Q

Complications of peptic ulcer disease includes ___

A

Bleeding, anemia, and bowel perforation

68
Q

Inflammation of the gall bladder

A

Cholecystitis

69
Q

A patient with cholecystitis will have ___

A

Fever and RUQ pain that may radiate to the shoulder. May also have jaundice

70
Q

Cholecystitis is dangerous because ___

A

The infection can spread to the blood causing sepsis and shock

71
Q

When patients strain to have a bowel movement, they can ___

A

Stimulate the vagus nerve, which can cause a vasovagal responce

72
Q

Vasovagal response

A

HR drops dramatically and the patient becomes dizzy or passes out

73
Q

In general, patients with GI issues are agitated and are unable to find ___

A

A comfortable position

74
Q

When assessing patients with GI problems, ask about ___

A

NSAID and alcohol use

75
Q

Presentation of GI issues can include ___

A
  1. Pale or yellow, thin skin
  2. Frail musculoskeletal system
  3. Peripheral, sacral, and periorbital edema
  4. Hypertension
  5. Fever
  6. Tachycardia
  7. Dyspnea
76
Q

___ vital signs can help determine if a patient is hypovolemic

A

Orthostatic

77
Q

With orthostatic vitals, wait ___ after the patient stands up to take the vitals again

A

2 minutes

78
Q

AAA

A

Abdominal Aortic Aneurysm

79
Q

AAA tends to develop in people who have a history of ___

A

Hypertension and atherosclerosis

80
Q

AAA most commonly reported as ___

A

Abdominal pain radiating through to the back

81
Q

If they AAA is large enough, it can be felt ___

A

As a pulsating mass just above and slightly to the left of the navel

82
Q

Occasionally the AAA causes a decrease in blood flow to ___

A

One of the legs

83
Q

Responsible for maintaining the body’s fluid and electrolyte balance and have important roles in maintaining the body’s long-term acid-base balance and eliminating drugs from thebody

A

Kidneys

84
Q

Adult kidney weight

A

8 - 9 oz

85
Q

70-year old kidney weight

A

6 - 7 oz

86
Q

The kidney’s decline in weight is due to ___

A

The loss of functioning nephron units, or tubule degeneration, translating into a smaller effective filtering surface

87
Q

Renal blood flow decreases by as much as ___ as a person ages

A

50%

88
Q

Why are older people prone to dehydration?

A

Loss of thirst mechanism, and kidneys respond slowly to sodium deficiency

89
Q

Two major type of incontinence

A
  1. Stress
  2. Urge
90
Q

Incontinence that occurs during activities such as coughing, laughing, sneezing, lifting, and exercise

A

Stress

91
Q

Incontinence that occurs when you have a sudden urge to urinate

A

Urge

92
Q

The urinary bladder contracts when it shouldn’t, causing some urine to leak through the sphincter muscles

A

Urge incontinence

93
Q

Opposite of incontinence

A

Urinary retention or difficulty urinating

94
Q

Enlargement of the prostate can place pressure on the ___

A

Urethra

95
Q

In severe cases of urinary retention, patients may experience ___

A

Renal failure

96
Q

Significant endocrine change in older people

A
  1. Decreased metabolism of thyrozine
  2. Increase in secretion of antidiuretic hormone
  3. Hyperglycemia
  4. Increase in levels of norepinephrine
97
Q

Affects the body’s metabolism, temperature, growth, and HR

A

Thyroid hormone

98
Q

A reduction in thyroid hormones

A

Hypothyroidism

99
Q

Signs and symptoms of hypothyroidism

A
  1. Slower HR
  2. Fatigue
  3. Drier skin and hair
  4. Cold intolerance
  5. Weight gain
100
Q

HHNS

A

Hyperosmolar hyperglycemic nonketotic syndrome

101
Q

HHNS occurs more often in people with ___

A

Type 2 diabetes than those with type 1

102
Q

Difference between HHNS and DKA

A

High blood glucose level does not cause ketosis; instead leads to osmotic diuresis and a shift fluid to the intravascular space that results in dehydration

103
Q

Signs and symptoms shared by HHNS and DKA

A
  1. Hyperglycemia
  2. Polydipsia
  3. Polyuria
  4. Polyphagia
  5. Dizziness
  6. Confusion
  7. Altered mental status
  8. Possibly seizures
104
Q

Blood glucose level in HHNS vs DKA

A

600 mg/dL or higher while DKA can vary

105
Q

Respiration differences between HHNS and DKA

A

DKA has Kussmaul respirations while HHNS will not

106
Q

What causes decrease in height?

A

Vertebrae disks narrow, and then from the process of osteoporosis in the vertebral bodies

107
Q

Forward curling of the spine

A

Kyphosis

108
Q

Condition characterized by a decrease in bone mass leading to reduction in bone strength and greater susceptibility to fracture

A

Osteoporosis

109
Q

Who is affected most by osteoporosis?

A

Women after menopause

110
Q

Treatments for osteoporosis

A
  1. HRT
  2. Calcium and vitamin D supplements
  3. Diphosphonates
111
Q

Progressive disease of the joints that destroys cartilage, promotes the formation of bone spurs in joints, and leads to joint stiffness

A

Osteoarthritis

112
Q

Exocrine glands

A

Sweat glands

113
Q

Decubitus ulcers

A

Bed sores or pressure ulcers

114
Q

Bed sores can form as quickly as ___

A

45 minutes

115
Q

Decubitus ulcer stages

A
  • Stage I: Nonblanching redness with damage under the skin
  • Stage II: Blister or ulcer that can affect the dermis and epidermis
  • Stage III: Invasion of the fat layer through to the fascia
  • Stage IV: Invasion to muscle or bone
116
Q

Bone infection

A

Osteomyelitis

117
Q

Decubitus ulcer complications

A
  1. Painful
  2. Bleeding
  3. Sepsis
  4. Osteomyelitis
118
Q

The use of multiple prescription medications by one patient

A

Polypharmacy

119
Q

Created to help remember the differences in older patients compared with the rest of the population

A

GEMS diamond

120
Q

GEMS

A
  1. Geriatric patients
  2. Environmental assessment
  3. Medical assessment
  4. Social assessment
121
Q

ADLs

A

Activities of daily living

122
Q

Why are older people more prone to cerebral bleeding following trauma

A

Brain shrinkage

123
Q

Questions to ask for a geriatric patient with a potential brain injury

A
  1. Long-term abuse of alcohol
  2. Recurrent falls
  3. Repeated head injury
  4. Use of anticoagulant medication
124
Q

MRSA is primarily spread by ___

A

Broken skin-to-skin contact but is also acquired by touching objects that have the bacteria on them

125
Q

Enterococci are bacteria normally present in ___

A

Human intestines and female reproductive tracts

126
Q

VRE

A

Vancomycin-resistant enterococci

127
Q

VRE is commonly found in ___

A

Hospitals

128
Q

MRSA is common among people who ___

A

Live in close quarters, such as nursing homes

129
Q

RSV

A

Respiratory syncytial virus

130
Q

RSV causes ___

A

Infection of the upper and lower airway tracts

131
Q

RSV is highly contagious and found in ___

A

Discharges from the nose and throat of an infected person. Transmitted from direct contact with droplets from coughs and sneezes and by touching a contaminated surface

132
Q

Bacterium responsible for the most common cause of hospital-acquired infections diarrhea and regularly causes sporadic cases of diarrhea in nursing homes

A

Clostridium difficile

133
Q

C diff normally grows in the ___

A

Intestines

134
Q

Categories of elder abuse

A
  1. Physical
  2. Psychological
  3. Financial

Emergency Medical Technician (100 decks)

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