Geriatrics Flashcards
What 7 things to consider as part of a geriatric assessment?
Meds Functional ability Fall risk vision Cognitive and mental health Vaccinations Other physical health Social support
indications for a geriatric assessment include age and what 7 things?
Chronic comorbididies Chronic mental health problems Cognitive changes Goes to the doc a lot Change in living that might lead to fall Uses multiple pharmacy Change in overall health
What is the best approach to help a geriatric patient?
Team approach
What is a major concern with meds and elderly patients? 2 main ideas here?
One because they take so many meds, older people generally cannot tolerate all the adverse effects as well so that will lead to problems.
Second, older people are seeing many more doctors and using different pharmacies and there is not good med management so drug to drug adverse effects is a big deal.
What are the 2 drug to drug interactions to know?
Ginkgo can increase bleeding
St John Warts can cause crazy high levels of serotonin when taking a SSRI
3 things to consider with the metabolism of drugs in older patients?
Reduced hepatic blood flow
Reduced kidney blood flow
Many older patients have some degree of chronic kidney disease
What are the three categories of the beers criteria?
Meds to always avoid in older people
Meds that are inappropriate for older patients with certain medical conditions
Meds used with caution
What is the stopp criteria for prescribing meds to older patients?
Similar to beers but included drug to drug interaction and duplication of drugs within classes
Screening tool of older persons prescriptions
What is the START criteria for prescribing meds?
Screening tool to alert docs to the right treatment
22 evidence based prescribing indicators for older patients
What is the general idea of medication assessment for an older patient?
Have them bring in everything they are taking, prescribed, OTC supplements, everything and discuss it all.
What are we talking about when we say functional ability of an older person?
How is there ability to perform activities of daily living
What are the two useful scales to use for testing functional ability?
Katz independence index and Lawton
4 common pathologies for visions for the elderly?
Glaucoma
MD
Cataracts
diabetic retinopathy
What two vision conditions to refer to eye doc?
Diabetic retinopathy and risk of glaucoma
2 tests/evaluations to use for fall risk assessment?
Tinneti balance and gait
Get up and go test
What are some things we can do during the physical exam to test for cognition?
Mental status Cranial nerves Gait and balance Strength Sensation Reflexes
2 screening tools for cognition?
Mini mental exam and MOCA
How can we best screen for depression in the elderly?
Use the two question method first.
In the past month have you been bothered by feeling down
In the past month have you been bothered by having little interest in doing anything
If either are yes go with the PHQ9 questionnaire
What is the most common hearing condition in the elderly?
Age related sensorineural hearing loss
2 clinical signs of old people having hearing loss?
Hearing loss with ringing in the ears
Vertigo/off balance
2 things we can do on physical exam for hearing and 1 treatment?
Look in the ears, whisper test
Hearing aids
3 things to assess for incontinence?
History
PE
Postvoid residual volume, stress test
3 ways to treat stress incontinence? 4 ways to treat urge? 2 ways to treat overflow?
Fluid restrictions, strengthen pelvic floor, anticholinergic
Fluid restrictions, pelvic floor, pessary, and alpha agonist
Indwelling catheter and alpha antagonist
What are the two recommendations the USPSTF gives for screening or osteoporosis?
DEXAMETHASONE scan on women 65 and older
Screen women younger than 65 whose 10 year fracture risk is high (use Frax fracture risk assessment tool).
