Geriatrics Flashcards
What activities correlate with 1, 4, AND 10 metabolic equivalents
1 = studying apex, walking 2 blocks leisurely, ADLs
4 = 2 flights of stairs, light housework, gardening, walking up a hill >1 - 2 blocks, raking leaves
10 = running
What is the metabolic rate for a MET
3.5 mL/kg/m per MET
How does minute ventilation change in the elderly?
it increases to compensate for increased deadspace
Lung elasticity & elderly
decreases
= increased Vd, decreased alveolar surface area, V/Q mismaatch, increased A-a gradient, decreased PaO2
Chest wall compliance
decreased because the chest is stiffer. this is due to
calcification of joints, diaphragmatic flattening, increased A-P diameter, decreased intervertebral disc height, decreased lung elastic recoil
Why does residual volume increase in the elderly?
Increased air trapping d/t reduced elastic recoil.
when does closing capacity surpass FRC?
45 y.o. when supine
65 y.o. when standing
how does arterial compliance change in the elderly?
increased SVR = increased BP
increased pulse pressure
increased myocardial hypertrophy
this is all due to loss of elastin and increased collagen
myocardial compliance
decreased
= diastolic dysfunction
systolic vs diastolic changes
systolic has no change
describe the autonomic changes that occur in the elderly
Increased SNS
decreased PNS
decreased baroreceptor sensitivity
increased levels of catecholamines but decreased response to them
how does MAC change
6% decrease per decade post 40 y.o.
postop delirium vs postop cognitive dysfunction
-delirium onset immediate
-delirium treaated with antipsychotics, minimizing polypharamcy
-POCD = weeks - months onset. no specific treatment
how does the GFR change
decreases by 1 mL/m/year after age 40.
normal = 125 mL/m
consequences = risk of fluid overload bc less plasma delivered to the nephrons per unit time. and impaired drug elimination (dosage adjustment if > 60)
how do serum creatinine and cr cleaarance change
serum creatine does not change.
CrCl decreases (most sensitive indicator in elderly**
