geriatrics Flashcards
most common early sign of aging
difficulty staying up all night and working the next day
most common cause of abdominal operations in elderly
biliary tract disease
most common cause of acute pancreatitis in elderly
gallstones
presentation of ruptured aaa
hypotension
abdominal pain
back pain
key finding is enlarged tender aorta
activities of daily living
bathing dressing eating toileting ambulating transferring
instrumental activities of daily living
making food managing checkbook (money mngmnt) using telephone shopping transportation ability to take meds housekeeping laundry
most common primary psychiatric disorder in elderly
depression
causes of delirium
i watch death infections withdrawal acute metabolic trauma cns pathology hypoxia deficiencies (thiamine, b12, niacin) endocrinopathies acute vascular toxins or drugs heavy metals
modifiable causes of dementia
meds alcohol metabolic (b12, thyroid, hyponatremia, hypercalcemia, hepatic and renal dysfucn) depression cns neoplasms/ chronic subdural hematoma NPH
sige caps
sleep interest guilt energy concentration appetite psychomotor suicide
most common cause of death from adverse drug rxn
gi bleed, intracranial bleed, renal failure
drugs associated w/ adverse events
antithrombotics- bleeds
antidiabetics- hypoglycemia, renal failure
diuretics- electrolyte imbalance, dehydration
nsaids- ulcers, gi bleed, renal failure, heart failure
drug metabolism different in elders
liver- hepatic blood flow decreases which decreases first pass metabolism (need less drug)
kidneys- renal perfusion decreaes
decreased lean body to fat ratio- distribution of drugs
decreased serum protein- drugs that are protein bound altered
stopp
screening tool of older person potentially inappropriate prescription
start
screening tool to alert prescribers to right treatment most common drug omissions: statins- atherosclerosis warfarin- a fib anti platelet tharpy- arterial dises vitamin d/ calcium- osteoporosis
first line for depression
behavioral therapy
should you use meds to get a1c below 7.5 in adults >65
no
should you treat elders w/ bacteriuria that are ASYMPTOMATIC
NO
leading cause of irreversible blindness in world
glaucoma
central vision loss
macular degeneration
peripheral vision loss
glaucoma
leading cause of reversible blindness in world
cataract
indications for hospitalizations from pneumonia
curb 65 confusion bun >20 respiratory >30 bp (systolic <60) greater then 65
score of 2 hospitalize
3-4 icu
what 3 pain meds to not use
amitriptiline
propoxyphene
demerol
goal for bp control
<140/90
1 cause of sub arachnoid hemorrhage
aneurysm
1 cause of intracerebral hemorrhage
hypertension
how long after stroke can you give tpa
3 hours
polymyalgia rheumatica
morning stiffness
pain in shoulders, neck, and pelvic girdles
what virus has polymyalgia rheumatica been associated w/
respiratory syncitial virus (RSV)
most useful lab for polymyalgia rheumatic
esr
main tx for polymyalgia rheumatica
prednisone
transient causes of incontince
diappers delirium infxn atrophy pharmceuticals psychogenic endocrine or excess urine output restricted mobility stool impaction
