Brainscape's Knowledge GenomeTM

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


See full index

PCM2 Midterm > Geriatric Endocrine Disorders > Flashcards

Geriatric Endocrine Disorders Flashcards

1
Q

Diabetes Mellitus Presentation

A 
Frequent Urination
Feeling very thirsty
Extreme fatigue
Blurry Vision
Cuts and bruises that are slow to heal
Tingling, pain, numbness in hands and feet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Diagnosis of DM

A
  • Fasting plasma glucose level of 126 mg per dL or greater
  • A1C level of 6.5% or greater
  • A random plasma glucose level of 200 mg per dL or greater
  • A1C greater than 5.7 impaired glucose level
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Consequences of Diabetes Mellitus

A

frequent infections (urinary tract (yeast), skin (cellulitis)
Retinopathy
Nephropathy
Neuropathy of feet and hands (ulceration, gangreen)
Vascular changes

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

Type 2 DM

A 
obese
impaired insulin secretion/increased resistance
no DKA
polydipsia, polyruria, nocturia
target AIC is less than 7
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Acanthosis Nigracans

A

black spots on the neck associated with DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Testing for Diabetic Neuropathy

A
  1. check for skin lesions
  2. pressure sensation using monofilament testing
  3. vibration sensation using tuning fork
  4. superficial pain using pinprick or temperature sensation
  5. reflexes,
  6. pulses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Diabetic Peripheral Neuropathy D

A

damage to peripheral nerves due to poorly controlled blood sugar
“stocking and glove pattern”
burning, paresthesia, usually distal, symmetric polyneuropathy
complications: ulcer formation–>infection
treatment: good control of blood sugar: less than 6.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ominous Octet of Hyperglycemia in Type 2 DM

A
  • increased lipolysis and reduced glucose uptake
  • increased glucose reabsorption
  • decreased glucose uptake
  • decreased incretin effect
  • increased hepatic glucose production
  • increased glucagon secretion
  • imparied insulin secretion
  • Neurotransmitter dysfxn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Documentation of Diabetic Foot Exam

A
  • No lesions callus on examination of feet, toes, in between toes
  • dorsalis pedis pulse: +2
  • vibratory senes intact bilaterally
  • decrease sensation to monofiliment in left lateral food, right great toe vs sensation intact to monofilament
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Metabolic Syndrome

A

“Syndrome X or Insulin Resistance Syndrome”

  • abdominal obesity
  • insulin resistance
  • elevated blood pressure
  • lipid abnormalities

prevalence increases with age and body weight

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

Increased Risk of Developing Metabolic Syndrome

A
  • antispyschotics
  • antivirals
  • steroids
  • PCOS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Causes of Adverse Drug Events

A
  • adverse drug reaction
  • medication error
  • therapeutic failure
  • adverse drug withdrawal event
  • overdose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Beer’s Criteria

A
  • Medications to avoid with other patients
  • medications that are potentially innapropriate for older patients with certain medical conditions
  • medications to use with caution
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Medication Assessment

A
  • patient brings in all meds and supplements
  • what are your prescription meds, OTC meds, supplements?
  • review meds EVERY visit
  • uses beer’s criteria to reduce or avoid prescribing meds that leads to adverse events
  • **Start low and go slow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Functional Ability

A

ability of patient to perform ADLs (self care and living independently)
Katz index
Lawton instrumental activities of daily living scale

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

Katz Index

A

You get a point for each:

  • bathing
  • dressing
  • toileting
  • transferring
  • continence
  • feeding
17
Q

Vision Pathologies

A 
increase with age
glaucoma
cataracts
macular degeneration
vision clarity
loss of periphreal vision
DM retinopathy
18
Q

Vision Assesment

A

periodic assessment with Snellen Eye Chart
refer to opthomology for diabetic retinopathy
refer to opthamology for patient with increased risk of glacoma

**assess for safety in driving

19
Q

Fall Risk Assessment

A

tinetti balance and gait evaluation

get up and go test

20
Q

Fall Reduction

A 
exercise
PT
assess home for hazards: carpet and rugs
review meds
asess vision
perform neuro exam
21
Q

Increased Risk for Depression is associate with what?

A

increase in age

22
Q

Comorbidities of old age are associated with what?

A

Decline in cognition

23
Q

Testing for Cognition

Neuro physical exam

A 
mental status
cranial nerves: vision screening
cerebellar status
strength
sensation
reflexes
24
Q

MOCA

A

tests cognition

  • consciousness
  • attention and concentration
  • memory
  • language
  • visuospatial preception
  • calculations
  • executive findings
  • mood and thought
25
Q

Depression Assessment

A
  • inability to perform ADL
  • social isolation
  • -during the past month, have you ever been bothered by feeling down, depressed, hopeless?
  • during the past month, have you ever been bothered by little interest or pleasure in doing things?

Yes—> patient health questionaire 9

26
Q

Hearing

A

Presbycusis: age related sensorineural hearing loss is most common in older patients
—progressive-symmetric loss of high frequency hearing
presents as vertigo and tinnitus

27
Q

Presbycusis

A

Presbycusis: age related sensorineural hearing loss is most common in older patients
—progressive-symmetric loss of high frequency hearing
-presents as vertigo and tinnitus
caused by loss of cochlear hair cells and ganglion celss

28
Q

Urinary incontinence

A

affects self esteem, emotional, social distress
Dx type of incontinence:
-good hx
-physical exam: fluid overload? genital/rectal exam w/ neuro exam

start assessment with “ is your incontinence caused by stress, coughing, sneezing, lifting, walking, running?”

29
Q

Stress incontinence

A

involuntary leakage of urine that occurs with increased in intra-abdominal pressure (exertion, sneezing, coughing, laughing)

30
Q

Urge Incontinence

A

detrusor muscle overactivity, leading to uninhibited detrusor muscle contractions during bladder filling

31
Q

overflow incontinence

A

continuous urine leakage due to incomplete bladder emptying

detrusor muscle under-activity or bladder outlet obstruction

32
Q

Osteoporosis

A 
causes progressive bone loss
increase fracture risk
Risk factor: white female, older white male, post menopausal, vit d deficiency 
**Dexa scan 65 and older
Frax fracture risk
33
Q

Management and Treatment of Osteoporosis

A

lifestyle change: fall prevention, smoking cessation, moderation of alcohol intake
hormone therapy

34
Q

OP diagnosis

A

spinal or hip BMD greater than 2.5 SD

–Severe OP: BMD>2.5 with presence of 1+ fragility fracture

35
Q

Osteopenia

A

BMD between 1 and 2.5 SD

36
Q

Vaccination Assessment for Geriatric patients

A

tetanus or tetanus with pertussis vaccine
influenza vaccine
pneumococcal vaccine
herpes zoster

37
Q

Social Support Assessment

A 
is there a plan for when you can no longer perform ADLS? 
social work or home referrals
what is the patients advance directive? 
Do they have health care POA? 
Assess for elder abuse

PCM2 Midterm (8 decks)

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