Geriatrics 3

Question 1

Which factor is unchanged in the geriatric patient?
a. creatinine clearance
b. serum creatinine
c. glomerular filtration rate
d. aldosterone

Answer 1

b. serum creatinine

Question 2

GFR __________________ after age 40

Answer 2

decreases by 1 mL/min/year

Question 3

What happens to renal blood flow as we age?

Answer 3

decreased

Question 4

What happens to renal mass as we age?

Answer 4

decreased

Question 5

What happens as response to antidiuretic hormone as age?

Answer 5

decreased

Question 6

What happens as response to aldosterone as we age?

Answer 6

decreased

Question 7

What happens to creatinine clearance as we age?

Answer 7

decreased

Question 8

What happens to response to acid load as we age?

Answer 8

decreased

Question 9

____________ is a poor indicator of renal function in the elderly

Answer 9

Serum creatinine

Question 10

Renal blood flow decreased by __________ per decade

Answer 10

10%

Question 11

Decreased renal mass results in

Answer 11

impaired ability to concentrate urine

Question 12

_____________ is the most sensitive indicator of renal function and drug clearance in the elderly

Answer 12

creatinine clerance

Question 13

Consequences of reduced GFR in the elderly include

Answer 13

increased risk of fluid overload
decreased elimination of hydrophilic drugs

Question 14

Decreased aldosterone in the elderly patient leads to

Answer 14

decreased ability to conserve sodium and increased risk of dehydration

Question 15

The following decrease as a normal response to aging EXCEPT:
a. albumin
b. pseudocholinesterase
c. alpha-1-acid glycoprotein
d,. hepatic blood flow

Answer 15

c. alpha 1 acid glycoprotein

Question 16

What happens to hepatocellular function as we age?

Answer 16

no change

Question 17

What happens to hepatic mass as we age?

Answer 17

decreased

Question 18

What happens to hepatic blood flow as we age?

Answer 18

decreased

Question 19

What happens to perioperative hepatic function as we age?

Answer 19

decreased

Question 20

What happens to albumin production as we age?

Answer 20

decreased

Question 21

What happens to pseudocholinesterase production as we age?

Answer 21

decreased

Question 22

What happens to alpha-1-acid glycoprotein production as we age?

Answer 22

increased

Question 23

what happens to phase 1 & 2 reactions as we age?

Answer 23

phase 1- decreased
phase 2- no change

Question 24

What happens to first pass metabolism as we age?

Answer 24

decreased

Question 25

Increased alpha 1 acid glycoprotein production leads to ______________ in the elderly whereas decreased albumin production leads to ________ in the elderly

Answer 25

increased reservoir for basic drugs; decreased reservoir for acidic drugs

Question 26

How does aging affect the pharmacokinetics of anesthetic drugs? (select 2)
a. faster induction with etomidate
b. faster induction with sevoflurane
c. increased volume of distribution of propofol
d. increased volume of distribution of rocuronium

Answer 26

b. faster induction with sevoflurane
c. increased volume of distribution of propofol

Question 27

Describe the circulation time as we age?

Answer 27

increased

Question 28

Describe the total body fat as we age?

Answer 28

increased

Question 29

Describe the lean body mass as we age?

Answer 29

decreased

Question 30

Describe the plasma protein binding as we age?

Answer 30

decreased

Question 31

Describe the rate of recovery from volatile anesthetics as we age.

Answer 31

proloned

Question 32

Describe the surface area to body mass ratio as we age.

Answer 32

increased

Question 33

Describe IV induction vs. inhalation induction in the elderly patient.

Answer 33

IV induction- prolonged
inhalation induction- faster

Question 34

The elderly patient has a small volume of distribution for

Answer 34

hydrophilic drugs

Question 35

Age does not affect pharmacodynamic effects of __________ but the duration of _____________ is increased if _____–

Answer 35

neuromuscular blockers; steroidal NMBs if renal or hepatic clearance is reduced