Geriatrics

Question 1

What causes changes associated w/ aging?

Answer 1

Gradual loss of homeostatic mechanisms

Question 2

What does functional performance of an organ in older people depend on?

Answer 2

• rate of deterioration

- level of performance

Question 3

What is the hallmark of aging associated w/?

Answer 3

not w/ how an organ performs at rest but rather during external stress

Question 4

What are ill defined symptoms?

Answer 4

Confusion, change in endurance, loss of appetite, nausea

*Take the place of typical sx

Question 5

What is failure of the stress response?

Answer 5

Atypical presentation in older persons

• Ex. failure to mount a white count or fever in response to infection

Question 6

Changes in aging can work together to produce…

Answer 6

a normal-appearing resting state

Question 7

What can be the 1st sign of a lower respiratory tract infection?

Answer 7

RR >25/min

Question 8

Why can BP be overestimated in elderly?

Answer 8

Due to stiff arteries

Question 9

What happens to the skin as you age?

Answer 9

• Wrinkles, becomes lax & loses turgor

- vascularity decreases

Question 10

What happens to the hair as you age?

Answer 10

• loss of pigment

- hair loss (genetic)

Question 11

What happens to the face as you age?

Answer 11

• eyebrows drop below superior orbital rim
• chin descends
• loss of angle btwn submandibular line & neck

Question 12

What happens to the eyes as you age?

Answer 12

• eyelid skin wrinkles
• lower lid fat pushes forward/bulges
• pupils become smaller/irregular

Question 13

What are 4 systolic murmurs in elderly?

Answer 13

• aortic valve stenosis
• aortic valve sclerosis
• mitral regurg
• hypertrophic CM

Question 14

What happens to the peripheral vascular system as you age?

Answer 14

• arteries lengthen, become tortuous, & feel harder

- increased stiffness & decreased endothelial fxn

Question 15

What happens to the respiratory system as you age?

Answer 15

…

Question 16

What happens to the abdomen as you age?

Answer 16

• muscles weaken
• decreased lipase activity w/ fat accumulation
• soft, protruding
• increased cardio risk
• can blunt manifestations of acute disease

Question 17

What do you do during GI physical exam for elderly?

Answer 17

• palpate abd for hernias due to weak muscles
• palpate for abd aortic aneurysm
• palpate for hepatosplenomegaly
• palpate/percuss surprapubic area for evidence of urinary retention

Question 18

What happens in the genitoruinary system in elderly men?

Answer 18

• sexual interest declines after age 75

Question 19

When does ovarian fxn begin to decline?

Answer 19

5th decade

Question 20

When do menstrual periods cease?

Answer 20

Btwn ages…

Question 21

What happens in the musculoskeletal system as you age?

Answer 21

Loss of cortical & trabecular bone

Question 22

What can happen to the feet as you age?

Answer 22

• hallux valgus
• hammer toe
• claw toe

Question 23

How do geriatric pts perform on the MSE?

Answer 23

Most perform well on MSE, but some impairments in memory may be apparent

Question 24

What happens to the CNs as you age?

Answer 24

• small pupils, sluggish pupillary light reflex
• limited upward gaze
• bell phenomenon

Question 25

What is a common age-related motor change?

Answer 25

Sarcopenia (decreased muscle mass)

Question 26

What sensory changes are seen w/ increased age?

Answer 26

• vibratory sense lost in feet, ankles

Question 27

Does aging have an effect on gait/posture?

Answer 27

Little effect

• shorter steps
• reduced gait velocity
• reduced joint motion

Question 28

Gait speed < 0.8 indicates…

Answer 28

poor clinical outcomes s/a physical & cognitive decline