Geriatric Patient

Question 1

What are the 3 subgroups for OS Geriatric patients?

Answer 1

• Young Old 65-75
• Older-old 75-85
• Old-Old 85+

Question 2

What are some Biomechanical Diagnoses as we age?

Answer 2

• Cervical stenosis
• Osteoarthritis (BOLDED)
• Osteoperosis
• Gait Changes
• Low back pain
• Carpal Tunnel Syndrome
• Inc. Fall Risk

Question 3

What are 3 goals of Geriatric treatment?

Answer 3

• Optimize function
• Avoid institutionalization
• Maintaining community involvement

Question 4

When do we see a Rapid increase in Osetoarthritis (OA)?

Answer 4

Rapid inc >50 years of age, levels around 80 yo

Question 5

What are some common symptoms to OA?

Answer 5

• Initial symptoms: pain in one joint
• Progress to involve multiple joints
• Deep ache, with use
• Joint stiffness after periods of inactivity – Just after waking up – Sitting
• Night pain, interference with sleep

Question 6

Phsyical Exam Findings with OA?

Answer 6

• Tenderness over joint line
• ROM reduction
• Bony swelling
• Joint deformity
• Instability
• X-ray: Osteophytes, narrowed joint
spaces

Question 7

How do we treat OA?

Answer 7

PAIN RELIEF: strengthening, OMT, oral meds, injections

PREVENTION

Question 8

What is the fastest growing Disability due to Neurological DO?

Answer 8

Parkinson’s DZ (PD)

Question 9

Who is affect for Parkinson’s age wise?

Answer 9

> 40 yo

Question 10

What are some physical exam findings for Parkinson DZ?

Answer 10

• Pill rolling
• Bradykinesia
• Cogwheel rigity
• Postural instability
• Shuffling Gait

Question 11

What are some Nonmotor symptoms for Parkinson DZ?

Answer 11

• Cognitive dysfunction
• Dementia
• Mood Disorders
• Sleep DO
• Fatigue
• Pain

Question 12

What is the 5th leading cause of death in the elderly?

Answer 12

Pneumonia

Question 13

What are some Risk Factor for Pneumonia?

Answer 13

• COPD
• Immunosuppression
• Smoking
• Congestive Heart Failure
• Diabetes
• Malignancy

Question 14

When an elderly person imobile their risk of pneumonia increases…

Answer 14

9 Fold!

Question 15

Why should you be cautious in giving Antibiotics to the elderly?

Answer 15

C- Difficile infections more likely w/ overuse

Question 16

What is a common practice for GI issues in a nursing home?

Answer 16

Laxatives! 74% use em daily

Question 17

What is the leading cause of injury among older adults?

Answer 17

FALLS

Question 18

What does the Get up and Go test assess?

Answer 18

Balance and Ambulation

Question 19

What are some Risk Factors to falling?

Answer 19

• Vit D Deficency
• Decreased strength/coordination
• Depression
• Medications
• Hazards at home
• SD! always!

Question 20

The suicide rates for older adults are how many times higher?
What population is it highest for?

Answer 20

• 2X Higher than general

- Highest for White Male > 85 Yo

Question 21

What are the interpretation of scores for Mini Mental State Exam?

Answer 21

Max 30
Mild 21-29
Moderate 10-20
Sever <9

Question 22

For a geriatric patient OMT it is important to keep them in…

Answer 22

A Single Position for all treatment modalities

Question 23

What is the amount of time that would increase a Fall risk with the Get up and Go test?

Answer 23

> 12 sec = Increased Fall risk

Question 24

A deconditioning Gait = Waddling Gait means …

Answer 24

Pelvis Weakness

Question 25

If there are mechanical changes in lower nack/pelvis/lower extremities this causes…

Answer 25

Antalgic Gait (Avoiding Gait)

Question 26

What are 3 gaits associated with Nerocompromise?

Answer 26

• Hemiparetic Gait (post stroke)
• Steppage Gait (Foot drop)
• Shuffling Gait (Parkinsons)