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Special Pops Geriatrics > Geriatric Syndromes > Flashcards

Geriatric Syndromes Flashcards

1
Q

What are some non-specific sx that may represent specific illness? (FYI 8)

A 
Confusion 
Self-neglect 
Falling 
Incontinence 
Apathy 
Anorexia 
Dyspnea 
Fatigue
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2
Q

Elderly pts often present w/ (typical/atypical) dz presentations

A

Atypical

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3
Q

What are atypical presentations of an acute abdomen in a geriatric pt?

A

Absence of sxs (silent presentation)
Mild discomfort and C
Tachypnea
Vague respiratory sxs

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4
Q

What medical illnesses can presents as depression in the geriatric population?

A

Hypo- and hyper- thyroid disease that presents as diminished energy and apathy

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5
Q

____ 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.

A

Mild Cognitive Impairment (MCI)

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6
Q

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

A

Alzheimer’s

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7
Q

Name that dementia!

Stepwise progression and or evidence of FND on exam

A

Vascular

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8
Q

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)

A

Frontotemporal

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9
Q

Name that dementia!

Trouble w/ stiffness and slowness starting insidiously around same time as cognitive loss, often 1st sx = visual hallucinations

A

Lewy Body

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10
Q

Name that dementia!

> 1 area of progressive cognitive impairment that persists after a pt w/ a hx of chronic EtOH abuse stops drinking

A

Wernicke-Korsakoff (EtOH related)

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11
Q

In an elderly pt w/ sepsis, or other infectious dz (such as ____, ____, ____, and ____) they may present without the usual (lab finding) ____ and (vital sign) ____

A

PNA, UTI, peritonitis, abscess
Leukocytosis
Fever

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12
Q

What is the triad for NPH (Normal pressure hydrocephalus)

A

Cognitive decline
Urinary incontinence
Falls

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13
Q

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.

A

Fatigue, N, decrease in functional status

SOB

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14
Q

In elderly pts w/ malignancy, they may report sx of _____ when they have a slow growing mass on their breast

A

back pain

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15
Q

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 ___.

A

PND, coughing, SOB

Change in function, food/fluid intake, confusion

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16
Q

In the elderly, hyperthyroidism presents as “____ ____” w/ sx of ___ and ____

A

Apathetic thyrotoxicosis

Fatigue and slowing down

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17
Q

In the elderly, hypothyroidism presents with sx of ____ and ____

A

confusion and agitation

18
Q

How can you test a pt when trouble w/ attention?

A

Ask them to raise their hand every time you say the letter “A”

19
Q

____ 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.

A

Delirium

20
Q

Is delirium a dz or a sx?

A

Sx

21
Q

What is included in the w/u for delirium–possible causes of delirium (x7)

A 
Infxn
Metabolic
Meds/Polypharmacy
Anesthesia
Malnutrition
Sensory Changes
Pain
22
Q

What % of the geriatric population is estimated to have depression?

A

25%

23
Q

What group of people have the highest suicide risk?

A

elderly white males

24
Q

In an elderly pt with depression, they may not reports any _____.
Instead, elderly pts with depression may present with ____ ____. Provide examples.

A

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
25
Q

What are other medical illnesses that can present as depression in the elderly?

A

Hyper and hypothyroidism, that present as a lack of energy and apathy

26
Q

What are some challenges that the caregiver of a dependent elderly pt face?

A

Missing work
handle logistics of finding addition care
increased stress, anxiety, depression, adverse physical effects

27
Q

What are some examples of common geriatric problems? (a lot, just be able to name a handful)

A 
3 D’s
Mobility and Falls
Pressure Wounds
Pain
Nutrition
Isolation
Vision Problems
Hearing Problems
Dizziness
Polypharmacy
Sleep
Incontinence/UTI
28
Q

Name that dx!

Triad: cognitive decline, falls, incontinence

A

Normal Pressure Hydrocephalus

29
Q

What can contribute to isolation in the elderly population?

A

Poor vision, hearing, mobility

urinary issues

30
Q

T/F Decreased mobility is normal in the elderly population

A

F: decreased mobility is never normal, you need to identify the cause

31
Q 
Describe the following stages of pressure sores:
Stage 1 \_\_\_\_\_\_\_\_\_\_
Stage 2 \_\_\_\_\_\_\_\_\_\_
Stage 3 \_\_\_\_\_\_\_\_\_\_
Stage 4 \_\_\_\_\_\_\_\_\_\_
Stage 5 \_\_\_\_\_\_\_\_\_\_
A

Stage 1 – Blanchable hyperemia

Stage 2 – Extension through the epidermis

Stage 3 – Full thickness skin loss

Stage 4 – Full thickness with extension into muscle bone or supporting structures.

32
Q

If eschar or slough overlies the wound, it is (unstageable/stageable).

A

unstageable

33
Q

What are 4 ways that you can prevent pressure sores?

A

Positioning
Nutrition
Vitamin C and Zinc
Special surfaces

34
Q

What are the 4 types of incontinence that a geriatric pt may experience?

A

Stress – cough
Urge – inability to delay
Overflow – bladder is not emptying
Functional – can’t get there in time

35
Q

A ___ (medical dx) can cause incontinence or retention and often presents as asymptomatic in the geriatric population

A

UTI

36
Q

___ is defined as increased Post Void Residuals

Extreme cases require a ____

A

retention

foley

37
Q

What are some transient causes of incontinence? (x8)

A 
Delirium
Infxn
Atrophic Vaginitis or urethritis
Excessive urinary output
Restricted mobility
Stool impaction
Meds
Psychological factors
38
Q

MCI is a dx that stands between the ____ decline in cognition and ___

A

normal, age-related

dementia

39
Q

T/F: Pts w/ MCI are not neurologically normal– their memory is worse than age-matched controls.

A

T

40
Q

Patients w/ MCI have a (higher/lower) rate of progression to dementia than age-matched controls

A

higher

41
Q

What should you do when working up a pt w/ dementia?

A

Evaluate for reversible causes

42
Q

What dx can have dementia as a sx? (x8)

A 
Alzheimer's
Vascular
Frontotemporal
Lewy Body
Parkinson’s
Wernicke- Korsakoff
Creutzfeldt-Jakob Disease (CJD)
NPH

Special Pops Geriatrics (8 decks)

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