Geriatrics Flashcards

1
Q

Age related changes to cardiovascular system

A
  • Unchanged cardiac output and cardiac index at rest
  • Increased myocardial hypertrophy
  • Decreased arterial elasticity
  • Reduced HR responsiveness to stress and respiration
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2
Q

Age related changes to respiratory system

A
  • Reduced lung volume due to loss of elastic recoil
  • Reduction in FEV1 and FVC
  • Increased RV
  • Increased V/Q mismatch
  • Decreased ventilatory response to hypoxia and hypercapnia
  • Reduced mucociliary clearance
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3
Q

Age related changes to GI system and liver

A
  • Decreased oesophageal peristalsis
  • Delayed gastric emptying
  • Decreased pancreatic enzyme secretion
  • Reduced liver volume, weight and blood flow
  • No changes to LFTs
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4
Q

Age related changes to endocrine system

A
  • Increased insulin resistance
  • Increased incidence of AI thyroiditis
  • Increased vasopressin with increased risk of hyponatraemia
  • Decreased basal renin level
  • Decreased aldosterone and increased risk of hyperkalaemia
  • Increased FSH/LH
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5
Q

Age related changes to immune system

A
  • Immunoglobulin levels remain stable
  • Diminished antibody response
  • Impaired T cell response, especially to viral infections
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6
Q

Features of renal artery stenosis

A

Resistant hypertension
Flash pulmonary oedema

Young women –> fibromuscular hyperplasia
Advanced age –> atherosclerotic disease of renal artery

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7
Q

Patients at risk of refeeding syndrome

A
  • poor oral intake > 5 days
  • exisiting electrolyte disturbance
  • low BMI
  • recent unintentional significant weight loss
  • history of alcohol abuse
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8
Q

What is fludrocortisone not recommended for?

A

Synthetic mineralocorticoid
Increased blood volume and improved blood vessel sensitivity to pressor agents
Not recommended for patients with nocturnal hypertension and CCF

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9
Q

MOA of midodrine

A

a1-adrenergic agonist
Increases BP by stimulating arterial and venous adrenoceptors to increase peripheral resistance

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10
Q

Risk associated with HRT

A

Breast cancer
VTE (no risk with transdermal HRT)
Cardiovascular disease and stroke risk (higher in those who start after 60 years old or 10 years after onset of menopause)

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11
Q

Management of venous ulcers

A

Compression is mainstay - graded multi-component > single component ones
Should be modified if ABI 0.6-0.9
Contraindicated if ABI < 0.6 (severe PVD)
Surgery can be done to promote healing

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