Geriatrics

Question 1

Body composition changes

Answer 1

1. loss of lean body mass
2. increased body fat
   3.decreased total body water

Question 2

Thermoregulation changes

Answer 2

1. decreased hypothalmus function, so impaired
2. longer lasting hypothermia

Question 3

The only CV change that does not occur is

Answer 3

No change in systolic function

Question 4

Respiratory changes: _____ chest wall compliance

Answer 4

DECREASED chest wall compliance

Question 5

Respiratory chagnes: Elastic recoil =

Answer 5

Loss of elastic recoil = reduced FUNCTIONAL alveolar surface area available for gas exchange

Question 6

Respiratory change: comliance

Answer 6

INCREASE in lung compliance (impairs v/q)

Question 7

Resp. changes: lung tissue elacticity

Answer 7

decreases

Question 8

Resp changes: net pulmonary compliance

Answer 8

virtually unchanged

Question 9

Resp changes: alveolar septae

Answer 9

breakdown =
1. increase anatomic and alveolar daed space
2. increase ventilation

=v/q mismatch

Question 10

Resp changes: shunt and physiologic dead speace

Answer 10

increase

Question 11

Res changes: vital capcity

Answer 11

decrease

(d/t increasing residual lung volumes and decrease in inspiratory and expiratory reserve volumes)

Question 12

OVerall resp changes: Min ventilation, lung compliance, lung elasicity, chest wall compliance

Answer 12

Question 13

Resp changes: FEV1 and FVC

Answer 13

decrease

Question 14

Resp changes: VC ERV IRV

Answer 14

decrease

Question 15

Resp changes: FRC RV

Answer 15

increase

Question 16

Resp changes: TLC

Answer 16

no change

Question 17

Elderly: CNS nerve tissue sensitivity to local anesthetics? Why?

Answer 17

Increased
-decreased # and diambeter of myelinated nerve fibers
-decrease in nerve conduction velocity

Question 18

Regional anesthetic sensitivty (intrathecals, epidurals)

Answer 18

Increased sensitivity to intrathecal anesthetics

increased sensitivty to epidural anesthetics

Question 19

Difficulty of neuraxial/spinals

Answer 19

increased difficulty

Question 20

Response to EPI test dose

Answer 20

decreased response to EPI test dose = greater risk of false negative responses (d/t reduced myocardial sensitivity to catecholamines)

Question 21

Drug DOA

Answer 21

prolonged

Question 22

Pharmacokinetics of prolonged drug DOA

Answer 22

1. decreased blood volume
2. Steady state volume varies
3. renal decline
4. hepatic delcine

Question 23

Elderly and vasopressors

Answer 23

Decreased sensitivity to vasopressors, may need longer to work

Question 24

Elderly pharm lipophillic drugs Vd

Answer 24

increased Vd

Question 25

elderly pharm hydrophillic drugs Vd

Answer 25

decrease in Vd

Question 26

Elderly lungs

Answer 26

inflate well and trap air

Question 27

Elderly closing volume

Answer 27

increases (small airways shut down due to increased residual volume overtime = early airway closure

Question 28

Elderly air closure

Answer 28

early airway closure

Question 29

Functional residual capacity

Answer 29

increases

Question 30

closing capacity

Answer 30

increases

Question 31

total lung capacity

Answer 31

no change

Question 32

Vital capacity

Answer 32

decreases

Question 33

inspiratory reserve volume

Answer 33

decreases

Question 34

residual volume

Answer 34

increases

Question 35

Expiratory reserve volume

Answer 35

decreases