Geriatrics Flashcards
Undernutrition, slowed motor performance, loss of muscle mass, or weakness suggests
frailty
Kyphosis or abnormal gait
impairs balance & increases risk for falls
Isolated systolic HTN (>140) after age 50
triples risk for CAD in men & increases risk of stroke
Pulse pressure (PP) >60 is a risk factor for
Cardiovascular & renal disease; & stroke
Lightheadedness, weakness, unsteadiness, visual blurring, & 20-30% of patients experience syncope
Symptoms of Orthostatic Hypotension
Respiratory rate >25 breaths per minute indicates
lower respiratory infection
translucent nodules that spreads & leaves a depressed center with firm elevated border
Basal Cell Carcinoma
firm reddish-appearing lesion often emerging in a sun-exposed area
Squamous Cell Carcinoma
dark raised asymmetric lesion with irregular borders may be
melanoma
______ may develop from obliteration of arteriolar & capillary blood flow to skin or from shear forces during movement across sheets or when lifted upright incorrectly
Pressure sores
world’s leading cause of blindness
cataracts
Cataracts risk factors
cigarette smoking, exposure to UV B-light, high alcohol intake, DM, some meds, & trauma
what disease is linked to cerebral microvascular changes & cognitive impairment
retinal microvascular disease
increased cup-to-disc ratio
open angle glaucoma - caused by irreversible optic neuropathy
causes poor central vision & blindness; drusen may be hard & sharply defined or soft & confluent with altered pigmentation
Macular Degeneration
____ may arise from periodontal disease
gingivitis
Increased tooth mobility from abscesses or advanced caries warrants
removal to prevent aspiration
increased anteroposterior diameter, purse-lipped breathing, & dyspnea with talking or minimal exertion suggests
chronic obstructive pulmonary disease
Isolated systolic HTN & widened pulse pressure are cardiac RF, prompting search for
Left Ventricular Hypertrophy (LVH)
A ______ can raise pressure in the left jugular veins by impairing drainage into right atrium.
tortuous atherosclerotic aorta
_____ can be hearted in aortic stenosis & carotid stenosis.
Carotid Bruits – Note: increased risk for ipsilateral stroke
Sustained PMI is present in
LVH
Diffuse PMI is present in
heart failure
In older adults an S3 suggests
dilation of left ventricle from heart failure or cardiomyopathy
S4 often accompanies
hypertension
Delay between the brachial & radial pulses during simultaneous palpation denotes
aortic stenosis
A harsh holosystolic murmur at apex that is common in older adults
mitral regurg.
Widened aorta & pulsatile mass on abdomen
abdominal aortic aneurysm (AAA)
if aortic width >3cm or with a pustule mass
Triple A (especially in older male smokers with coronary disease)
Diminished or absent pulses may indicate
arterial occlusion
<33% of patients with peripheral vascular disease have symptoms of
claudication
erythema with satellite lesions during genital exam
infection with Candida
Genital Exam: multifocal reddened lesions with white scaling plaques are seen in
extramammary Paget’s disease (an intraepithelial adenocarcinoma)
Clitoral enlargement may accompany
androgen-producing tumors or use of androgen creams
Mobility of cervix is restricted with
inflammation, malignancy, or surgical adhesion
A uterus that is enlarged, fixed, or irregular may indicate
adhesions or possible malignancy
Persistent blinking after glabellar tap & difficulty walking heel-to-toe
Parkinson’s disease
