Geriatrics (1305)

Question 1

General age when signs of aging starts to accelerate?

Answer 1

65

Question 2

Respiratory changes when you age?

Answer 2

• Chest wall becomes more rigid and accessory muscles weaken (reduced pulmonary capacity)
• Loss of cilia, dampened cough reflex and impaired gag reflex (increases risk of aspiration)

Question 3

Cardiovascular changes when aging?

Answer 3

• Increase in cholesterol deposits, thickening of arteries (more prone to MI/HTN)
• Arrhythmias (a-fib most common)
• Increase in afterload which decreases cardiac output; more prone to CHF

Question 4

Renal system changes when aging?

Answer 4

• Renal blood flow declines which decreases renal function
• Causes fluid retention which results in peripheral edema
• Severe renal disease can lead to hyperkalemia and cardiac arrest

Question 5

CNS when aging?

Answer 5

• Atrophy of brain tissue “shrinkage”
• Blood vessels become harder; more prone to occlusions
• Decrease in pain receptor sensitivity; pain threshold becomes higher
• Balance becomes impaired

Question 6

Muskuloskeletal changes when aging?

Answer 6

• Bones become weaker, usually secondary to:

a) Osteoporosis (thinning of bone)
b) Osteoarthritis (joint degeneration)

Question 7

Common medical conditions in elderly population?

Answer 7

• MI/Arrhythmia
• CHF/COPD/Pneumonia/PE
• UTI
• Diabetes
• Arthritis/osteoarthritis
• GI disturbances/bleeds
• CVA

Question 8

What should you do if you see depression in leads V1-V3?

Answer 8

15 lead

Question 9

Common medications for A-fib?

Answer 9

Eliquis, Xarelto, Pradaxa, Coumadin

Question 10

Left Ventricular Heart Failure?

Answer 10

When LV fails to be a pump

• Causes backflow into pulmonary circulation causing pulmonary edema
• Can present as blood tinged sputum

Question 11

Right Ventricular Heart Failure?

Answer 11

• Can result from LVF but also pulmonary hypertension
• Causes back pressure into venous system causing peripheral edema

Question 12

Pulmonary Edema?

Answer 12

• Can be cardiogenic from CHF
• Can be non-cardiongenic from drowning, ARDS, PE, etc
• Use CPAP for both, no nitro for non-cardiogenic

Question 13

What is Pneumonia?

Answer 13

Lung infections that can be bacterial, viral, or fungal

• Associated with fever and pleuritic chest pain (sharp pain with movement or deep inspiration)
• Can be unilateral or bilateral (course on auscultation)
• Can also present with wheezing

Question 14

What is Pulmonary Embolism?

Answer 14

Blockage of pulmonary artery

• Clot often occurs in lower legs (DVT) and breaks off travelling into heart, out of RV, and into pulmonary circulation
• Pts will have: dyspnea, cough, anxiety, tachycardia, low O2 sats
• Birth control and smoking is a common risk factor in young patients