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Clin Med II > Geriatrics > Flashcards

Geriatrics Flashcards

1
Q

what is the most under treated and under diagnosed illness in elders

A
  • depression
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2
Q

failure to thrive

A
  • cognition
  • function
  • mood
  • normal aging issues/ nutrition- esp hydration
  • deficit in any of the major domains
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3
Q

important functions to maintain

A
  • dressing
  • eating
  • ambulating
  • toileting
  • hygiene
  • home saftey
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4
Q

vision changes in the elderly

A
  • loss of accomidation
  • fibrosed retinas
  • loss of visual acuity
  • loss of 3D capability
  • unable to understand gray scale
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5
Q

hearing loss in the elderly

A
  • high pitched noises lost first
  • inability to sense position
  • dont know where sounds are coming from
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6
Q

loss of smell in the elderly

A
  • loss of olfactory neurons
  • taste buds change
  • lose sweet and salty
  • maintain bitter and sour
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7
Q

why does sundowning occur

A
  • impaired senses -> inability to interact with environment well
  • want to augment senses as much as possible to prevent
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8
Q

what is the most common cause of syncope in elders

A
  • vasovagal
  • sudden onset and slowly recover
  • sx- diaphroesis, vomiting, hypotension
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9
Q

causes of decubiti

A
  • immobility
  • shearing
  • moisture
  • friction
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10
Q

stage 1 decubiti

A
  • area over bony prominence is erythematous, doesnt blanch

- easily reversed by removing insult

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11
Q

stage 2 decubiti

A
  • wound extends into SQ fat but doesnt go deep into fascia or muscle
  • easily reversed by barrier cream or topicals
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12
Q

stage 3 decubiti

A
  • would goes beyond deep fascia and into muscle
  • not easily reversed
  • can get worse very quickly
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13
Q

stage 4 decbuiti

A
  • all the way through the muscle with risk of infection of bone
  • limb threatening
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14
Q

unstageable decubiti

A
  • skin remains intact
  • non-blanching, bruising, fluctuant
  • more difficult to treat and manage
  • may require imaging
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15
Q

frailty measures

A
  • weight loss
  • exhaustion
  • slow gait
  • weak grip
  • low energy output
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16
Q

what may be considered the 6th vital sign

A
  • frailty
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17
Q

how does dysphagia happen

A
  • decreased neck muscles
  • compromised airway -> risk of aspiration
  • esophageal dysmotility
  • sphincter compromise -> GERD
18
Q

why is B12 deficiency common in elderly

A
  • requires stomach acid to be absorbed

- elderly have reduced stomach acid

19
Q

C. diff

A
  • loose, watery, mucousy stool
  • foul smelling
  • yellow green
  • can cause sepsis
  • abdominal cramping
20
Q

risk factors for c diff

A
  • age
  • abx
  • in an institution > 2 weeks
  • exposure
21
Q

treatment for c diff

A
  • flagyl
  • PO vanco
  • time and fluids
  • possible fecal transplants
22
Q

types of urinary incontinence

A
  • urgency
  • stress
  • overflow
  • functional
23
Q

urgency incontinence

A
  • over active bladder
  • bladder spasms
  • frequency/ nocturia
24
Q

stress incontinence

A
  • compromised bladder closure or supportive structures

- bladder becomes easily overwhelmed

25
Q

overflow incontinence

A
  • bladder contracture issue
  • blockage of urethra
  • signals for bladder to evacuate dont occur or it becomes mechanically obstructed -> leak
26
Q

treatment for urinary incontinence

A
  • nonpharm first
  • kegel exercises
  • scheduled toileting
  • indwelling catheters
  • anticholinergics
  • alpha 1 antagonists if due to BPH
27
Q

McGreer criteria

A
  • used to help dx and treat UTI
  • constitutional sx- fever, leukocytosis, acute change in mental status, acute decline in fn
  • UTI infection sx
  • not based on changes in character of urine
  • urine culture required
28
Q

what is the most common cause of falls in elderly

A
  • muscle weakness
29
Q

what medications increase fall risk

A
  • SSRI
  • diuretics
  • sedatives
30
Q

why is it important to assess how long someone has bene down for?

A
  • less peripehral fat in elderly -> hypothermia risk
  • lungs can become impaired- airways do not open as well, more prone to pneumonia, weakened neck muscles
  • 5% muscle loss per day
31
Q

how do you assess delirium in elderly

A
  • confusion assessment method
  • mental status change
  • inattention
  • disorganized thinking
  • altered level of consciousness
  • need 1 and 2, either 3 or 4
32
Q

causes of delirium

A
  • infection
  • trauma
  • immobility
  • pain
  • pain meds
  • catheters
  • multiple transitions
33
Q

dementia

A
  • syndrome NOT a dx
  • memory impairment with:
  • chronicity (usually 9 months)
  • progression and irreversibility
  • may be slow and insidious
  • does not meet criteria for dilirium
34
Q

types of dementia

A
  • alzheimer’s
  • vascular disease
  • lewy body disease
  • frontotemporal disease
  • reversible causes
35
Q

lewy body disease

A
  • lewy bodies accumulate in or around substantia nigra which makes dopamine
  • parkinsonism, hallucinations
  • antipsychotics make it worse
36
Q

reversible causes of dementia

A
  • hypo/hyperthryoidism
  • B12 deficiency
  • medications
  • syphilis
  • blood loss
  • kidney/ liver disease
  • delirium
37
Q

mild cognitive impairment

A
  • doesnt satisfy all requirements for dementia
  • noticeable cognitive changes
  • doesnt interfere with ADLs or independent functioning
  • may progress to alzheimer’s or revert back to normal
38
Q

risk factors for dementia

A
  • HTN
  • diabetes
  • cholesterol
  • smoking
39
Q

main goals of dementia treatment

A
  • keep pt at home
  • maintain cognition
  • preserve function
  • improve behavior
  • coordinate care
40
Q

pharmacologic treatment for dementia

A
  • donepazil (aricept)
  • rivastigmine (exelon)
  • memantine as add on for mod- severe dementia
  • goa is to stabilize/ prevent worsening, NOT a cure
  • procholinergic meds
41
Q

alternative therapies that are effective for dementia

A
  • exercise
  • socialization
  • structure/ support

Clin Med II (16 decks)

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