Geriatric Syndromes - Test 3

Question 1

Name four common geriatric syndromes

Answer 1

DUFF beer:

Delirium

Urinary incontinence

Falls

Frailty

Question 2

What is the criteria for diagnosing frailty?

Answer 2

Unexplained weight loss

Fatigue

Weakness

Slow walking speed

Low levels of physical activity

Question 3

Name four strong predictors of future falls.

Answer 3

1. History of falls
2. Gait, strength, or balance deficits
3. Use of psychotropic meds
4. Hx of dementia or Parkinson’s

Question 4

Name three effective methods of fall prevention.

Answer 4

1. Exercise program that focuses on lower extremity strength and balance
2. Home safety modifications
3. Drug modification (eg. stop alpha-1 antagonists for BPH and use something else)

Question 5

FAST is a scoring tool for ________ and quantifies disease severity on a scale of ___ to ___.

Answer 5

Scoring tool for dementia - scale of 1 (normal) to 7 (severe dementia)

Question 6

What is the difference between basic ADLs and instrumental ADLs (IADLs)?

Answer 6

IADLs are more complex skills such as using a phone, cooking, managing finances, etc.

ADLs are basic care tasks (bathing, dressing)

Question 7

What is functional disability and what are the risk factors for it?

Answer 7

Functional disability is a loss of the ability to perform ADLs

Risk factors:

Cognitive impairment

Having multiple comorbidities

Depression

Lower extremity limitations

Sedentary lifestyle

Smoking

Impaired vision

Question 8

How can you easily assess functional status while taking a patient history?

Answer 8

Ask if they are doing ok with managing their meds, finances, or if they have trouble bathing. If there are problems, do a full assessment.

Question 9

Is the absorption of drugs in the GI tract changed in old age?

Answer 9

Absorption is unchanged, but first pass metabolism is decreased -> increased bioavailability

Question 10

Describe the changes in total body water and fat with old age and how this affects the pharmacokinetics of certain drugs.

Answer 10

Decreased body water -> increased plasma conc. (and reduced volume of distribution) of water-soluble drugs

Increased body fat -> increased half life (and volume of distribution) of lipid-soluble drugs

Question 11

Which phase of drug metabolism can slow down during old age?

Answer 11

Phase I (putting on polar functional groups)

Question 12

Which drug classes should be used with great precaution in the elderly?

Answer 12

Anything with anticholinergic properties:

• Antihistamines
• Antipsychotics
• Tricyclic antidepressants

Parkinson’s drugs

Opioids

SSRIs

Antiepileptic drugz

Benzos and non-benzo sedatives

Question 13

What is lag time to benefit?

Answer 13

The amount of time it will take for someone to benefit from an intervention or screening (eg. if prostate cancer takes 10 years to kill you, you shouldn’t screen someone who has a life expectancy of 5 more years)

Question 14

What is Medicare part A? What about part B?

Answer 14

Part A pays for shit that goes down in the hospital

Part B pays for outpatient stuff

Question 15

You are the doctor for a patient that has difficulty with nearly all ADLs and you need to recommend a housing option for them. What should you recommend?

Answer 15

Skilled nursing facility - can provide 24-hour care and rehab and has all levels of providers present