Geriatric Syndromes Flashcards
What are some non-specific sx that may represent specific illness? (FYI 8)
Confusion Self-neglect Falling Incontinence Apathy Anorexia Dyspnea Fatigue
Elderly pts often present w/ (typical/atypical) dz presentations
Atypical
What are atypical presentations of an acute abdomen in a geriatric pt?
Absence of sxs (silent presentation)
Mild discomfort and C
Tachypnea
Vague respiratory sxs
What medical illnesses can presents as depression in the geriatric population?
Hypo- and hyper- thyroid disease that presents as diminished energy and apathy
____ is memory loss noted by pt or family in which detailed testing shows abnormal memory, but pts have no functional impairment, and therefore do not meet the criteria for dementia.
Mild Cognitive Impairment (MCI)
Now for a fun game of Name That Dementia!
Short term memory loss w/ other cortical deficits→ problems w/ language and praxis, w/ relative preservation of social graces early in dz
Alzheimer’s
Name that dementia!
Stepwise progression and or evidence of FND on exam
Vascular
Name that dementia!
Prominent behavioral and personality changes early in the course of cognitive impairment; inhibition, trouble with the law, impulse control, reactivation of primal reflexes (“frontal release signs” - snout, grasp, and palmomental reflexes)
Frontotemporal
Name that dementia!
Trouble w/ stiffness and slowness starting insidiously around same time as cognitive loss, often 1st sx = visual hallucinations
Lewy Body
Name that dementia!
> 1 area of progressive cognitive impairment that persists after a pt w/ a hx of chronic EtOH abuse stops drinking
Wernicke-Korsakoff (EtOH related)
In an elderly pt w/ sepsis, or other infectious dz (such as ____, ____, ____, and ____) they may present without the usual (lab finding) ____ and (vital sign) ____
PNA, UTI, peritonitis, abscess
Leukocytosis
Fever
What is the triad for NPH (Normal pressure hydrocephalus)
Cognitive decline
Urinary incontinence
Falls
Elderly pts with MI may have vague sx such as ___, ___, and ___. The classic presentation of MI in the elderly is _____ as a more common complaint, rather than CP.
Fatigue, N, decrease in functional status
SOB
In elderly pts w/ malignancy, they may report sx of _____ when they have a slow growing mass on their breast
back pain
In an elderly pt w/ pulmonary edema, they may not present with the classic sx of __, ___, or ___. Instead, they may have an (insidious/acute) onset and present w/ ___, ___, or ___.
PND, coughing, SOB
Change in function, food/fluid intake, confusion
In the elderly, hyperthyroidism presents as “____ ____” w/ sx of ___ and ____
Apathetic thyrotoxicosis
Fatigue and slowing down
In the elderly, hypothyroidism presents with sx of ____ and ____
confusion and agitation
How can you test a pt when trouble w/ attention?
Ask them to raise their hand every time you say the letter “A”
____ is an acute mental status d/o characterized by abnormal and fluctuating attention. There is a disturbance in level of awareness and reduced ability to direct, focus, sustain, and shift attention.
Delirium
Is delirium a dz or a sx?
Sx
What is included in the w/u for delirium–possible causes of delirium (x7)
Infxn Metabolic Meds/Polypharmacy Anesthesia Malnutrition Sensory Changes Pain
What % of the geriatric population is estimated to have depression?
25%
What group of people have the highest suicide risk?
elderly white males
In an elderly pt with depression, they may not reports any _____.
Instead, elderly pts with depression may present with ____ ____. Provide examples.
sadness
somatic complaints (appetite changes, vague GI sx, constipation, sleep disturbances) *they may also be hyperactive
- *Sadness misinterpreted by provider as normal consequence of aging
- *Medical problems that mask depression
