Geriatrics Flashcards

1
Q

What is 1 MET?

A

3.5mLO2/kg/min

Or, about 250mL/min for 70kg patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Minute ventilation in the eldely

A

Increases to compensated for the increase in dead space 2/2 small airway closure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Lung elasticity

A

Decreases, resulting in slower of small airways and the lung to be overfilled with gas.

Increased dead space
Decrease alveolar surface area
Increased A-a gradient
VQ mismatch
Decreased PaO2
Altered lung volumes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Chest wall compliance

A

Decreased

This is because of:

  • Flatter diaphagm
  • Increased AP diameter
  • Decreased intercostal mass
  • Joint falcification
  • Loss of intervertebral disc height

Results in increased WOB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Consequences of loss of elastic recoil

A

Airways don’t spring back. They inflate, but don’t spring bag. It’s like inflating a plastic shopping bag. On exhalation, and pressure in the chest becomes positive, these flimsy airways collapse, and the air in the shopping bag is trapped.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does it mean when closing capacity surpasses FRC?

A

Closing capacity is the volume of air that must be in the lungs to prevent airway collapse.
If it surpasses FRC, it means that airways will collapse during normal tidal breathing.

This happens at age 45 in the supine position and will happen at age 65 in the standing position.

This collapse results in increased dead space, VQ mismatch, and a reduction in PaO2.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Vital capacity in elderly

A

Reduced.

The chest wall is less compliant and muscles are weaker and diaphragm is weaker. Can’t take in a huge breath.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is special about alpha 1 acid glycoprotein in the elderly?

A

It binds to basic drugs, and it’s production is actually INCREASED in the elderly

Acid binds with base!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Albumin binds what types of drugs?

A

Acidic drugs

Albumin is decreased in the elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pseudocholinesterase in the elderly

A

Decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Liver function in the elderly

A

Hepatocytes work normally!

What’s reduced is hepatic BF and hepatic mass. Periop hepatic function is decreased as well.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Phase I and II reactions in the elderly

A

Phase I (oxidation, reduction, and hydrolysis) are reduced.

Phase II (conjugation and acetylation) are unchanged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly