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Clin Med V and VI > Geriatrics > Flashcards

Geriatrics Flashcards

1
Q

Activities of daily living

A
  • bathing
  • dressing
  • eating
  • transferring from bed to chair
  • continence
  • toileting
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2
Q

What is the daily recommended dose for calcium supplementation?

A

1200-1500mg/day

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3
Q

Describe the daily dosing increments for calcium supplementation

A

500mg TID with each meal

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4
Q

When does the US Prevention Screen Task Force recommend stopping screening for breast cancer?

A

At 75 years

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5
Q

When does the American Geriatric society recommend stopping screening for breast cancer?

A

At 85 years

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6
Q

At what age do we stop performing colonoscopies? Why?

A
  • 85

- Because of the risk of perforation

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7
Q

According to colon cancer screening guidelines, how often should we perform a Flex Sig and FOBT?

A
  • Flex Sig every 5 years

- FOBT every 3 years

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8
Q

If we choose to screen our patients for colon cancer using only FOBT, how often should we perform that test?

A

Every year

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9
Q

If we choose to screen our patients for colon cancer using colonoscopy, how often should we perform it?

A
  • Every 10 years for ages 50-75

- Every 2 years for high risk patients

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10
Q

At what age do we stop screening women for cervical cancer, as long as they’ve had negative PAPS in the past and have no risk factors?

A

65-70 years

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11
Q

If a 70yo woman has no prior pap smear results, how many must we perform with negative results before we stop screening for cervical cancer altogether?

A

2

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12
Q

How often does Medicare cover pap smears and pelvic exams?

A
  • Every 24 months

- Or every 12 months if pt is high risk

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13
Q

What can we do to screen men for prostate cancer?

A

DRE and PSA yearly

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14
Q

At what age do we begin screening men for prostate cancer?

A

50 years

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15
Q

How often does Medicare cover PSA screening tests?

A

Every 12 months

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16
Q

Age-related SN hearing loss

A

Presbycusis

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17
Q

Most common form of SN hearing loss

A

Presbycusis

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18
Q

Key features of presbycusis

A

Bilateral, symmeric, high-frequency hearing loss

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19
Q

MC cause of conductive hearing loss

A

Cerumen impaction

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20
Q

Good drug to give patients SP surgery to prevent constipation

A

Colace (a surfactant)

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21
Q

Most frequently used type of laxative

A

Stimulants

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22
Q

Initial tx of choice for depression

A

SSRIs

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23
Q

TX of choice for depression with insomnia

A

Trazadone

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24
Q

Depression tx class that are not well tolerated in the elderly

A

TCAs

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25
Q

Depression tx that increases appetite

A

Rameron

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26
Q

You should suspect depression in patients with weight loss over what percent in 6 months?

A

> 10%

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27
Q

When do most traffic accidents involving seniors occur?

A
  • Turning left across traffic
  • At intersections
  • In daylight hours
  • In good road conditions
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28
Q

MC perpetrators of elder abuse

A

Adult children and spouses

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29
Q

How much does postprandial glucose increase each decade in the elderly?

A

Increases by 10mg/dL per decade

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30
Q

Why do we need lower doses of T4 to treat hypothyroidism in elderly?

A

Because there’s a decreased thyroxine clearance

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31
Q

What cholesterol changes occur in elderly women, and why?

A

Increased levels of LDLs due to an abrupt termination of sex hormone production

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32
Q

Erythematic change of the skin due to acute or prolonged heat exposure

A

Erythema ab igne

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33
Q

Significant fact to remember about Fluoroquinolones

A

Elderly require reduced doses…especially with renal dysfunction

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34
Q

Best antihypertensive for the elderly

A

HCTZ

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35
Q

HCTZ dose for HTN

A

12.5-25 mg/day

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36
Q

What % of calories should come from fat?

A

20-35%

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37
Q

How many grams of fiber should a patient consume per 1000calories?

A

14g

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38
Q

Drug used to prevent the first event of non-fatal MIs in patients with HTN

A

Beta blockers

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39
Q

What characteristic of Dementia Syndrome of Depression might lead you to make that diagnosis, rather than Alzheimer’s Disease?

A

DSD has a much more abrupt onset

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40
Q

Hypothyroidism tx

A

Low dose Synthroid

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41
Q

IADLs

A
  • Transportation
  • Shopping
  • Cooking
  • Managing money
  • Using the telephone
  • Taking medications
  • Housecleaning
  • Laundry
42
Q

How often do we administer the tetanus vaccination?

A

One dose every 10 years

43
Q

How often do we administer the Diptheria vaccine?

A

One dose every 10 years

44
Q

How often do we administer the Influenza vaccine?

A

Annually

45
Q

How often do we administer the Pneumococcal vaccine?

A
  • One dose, unless given < 65 years

- In that case, revaccinate after 5 years

46
Q

How often do we administer the Herpes Zoster vaccine?

A

Once after age 60

47
Q

What labs change with age?

A
  • Postprandial blood sugar
  • Serum cholesterol
  • ESR
  • T3
  • Renal function tests
48
Q

Leading cause of severe vision loss in patients >75

A

Macular degeneration

49
Q

Central vision loss that begins in one eye, then becomes a bilateral deficit

A

Macular degeration

50
Q

What physiologic changes leads to orthostatic hypotension in the elderly?

A

Decreased baroreceptor sensitivity

51
Q

BMD scan is recommended for all women over what age?

A

65 years and older

52
Q

Preferred tx for mild-moderate pain

A

Acetaminophen

53
Q

Max dose of Acetaminophen

A

3-4g/d

54
Q

Best drugs for inflammatory pain

A

NSAIDs

55
Q

Best drugs for moderate-severe pain

A

Opioids

56
Q

What types of side effects might you see with opioid use for pain management?

A

CNS side effects (sedation, confusion, reduced concentration, nausea, constipation)

57
Q

Drugs good for local pain

A

Topical Capsaicin or 5% Lidocaine

58
Q

The lens loses elasticity, thus losing the ability to focus and increases difficulty of seeing objects up close (pathology)

A

Presbyopia

59
Q

Skin lesion that looks brown-black and like it’s stuck onto the skin

A

Seborrhea keratosis

60
Q

Where does seborrhea keratosis typically occur?

A

Can occur anywhere

61
Q

Skin lesion secondary to thinning skin and dermal capillary rupture

A

Senile purpura

62
Q

What percent of actinic keratosis skin lesions will become SCC if left untreated?

A

5-10%

63
Q

Pt has a solitary, thick nodule on an erythematous base. No central depression or ulceration. Suspicion?

A

Squamous cell carcinoma

64
Q

Most common type of skin cancer?

A

Basal cell carcinoma

65
Q

Patient has a non-erythematous nodule with telangiectasias. You node a small depression in the middle. The nodule has a slight pearly color to it. Suspicion?

A

Basal cell carcinoma

66
Q

Often one of the first skin changes observed in aging patients

A

Sagging of the lateral aspects of the eyebrows

67
Q

Dry skin is most common on what parts of the body?

A
  • Anterior legs

- Extensor surfaces of arms and legs

68
Q

White epidermal cysts, approximately 1mm in diameter seen on sun-damaged skin

A

Milia

69
Q

1-5mm bright red papules

A

Cherry hemangiomas

70
Q

Where are cherry hemangiomas most common?

A

On the trunk

71
Q

Blue papules that tend to occur on the lower lips and ears

A

Venous lakes

72
Q

Components of continence

A
  • Effective function of the lower urinary tract
  • Adequate cognitive and physical control
  • Motivation
  • Appropriate environment
73
Q

Cause of urge incontinence

A

Involuntary bladder contraction

74
Q

Cause of stress incontinence

A

Increased abdominal pressure

75
Q

Cause of overflow incontinence

A

Overflow of urine from an over-distended bladder; unable to empty the bladder due to a neuropathy or obstruction

76
Q

When doing a post-void residual volume study, what residual volume is indicative of overflow issues?

A

> 300mL

77
Q

Drug tx for urge incontinence

A

Oxybutynin, Imipramine

78
Q

Drug tx for stress incontinence

A

Vaginal estrogen cream

Alpha-stimulating agent

79
Q

MC source of bacteremia in the elderly

A

UTI

80
Q

MC infection in nursing home patients

A

UTI

81
Q

What types of medications can increase a patient’s risk for a UTI? Why??

A
  • Anticholinergics

- Urinary retention

82
Q

How long do we typically treat patients for UTIs?

A

10-14 days

83
Q

What lab should we check before initiating Warfarin therapy?

A

Albumin concentration

84
Q

First-line tx for osteoporosis

A

Calcium and Vitamin D supplementation

85
Q

What types of drugs can lower serum calcium levels, leading you (the provider) to suggest supplementation?

A

Anti-ulcer/GERD medications

86
Q

What’s the most sensitive and cost effective procedure for colon cancer screening?

A

Colonoscopy every 10 years

87
Q

Gold standard for hearing screening

A

Whispered voice test

88
Q

Weber test results for conductive hearing loss

A

Sound will lateralize to the bad ear

89
Q

Rinne test results for conductive hearing loss

A

BC > AC or BC = AC

90
Q

Weber test results for SN hearing loss

A

Sound will lateralize to the good ear

91
Q

Rinne test results for SN hearing loss

A

AC > BC

92
Q

Laxative that’s safe and reasonable for long-term use

A

Polyethylene glycol (PEG, Miralax), which is a hyperosmolar agent

93
Q

Drug that’s particularly effective in treating resistant constipation

A

Polyethylene glycol (PEG, Miralax), which is a hyperosmolar agent

94
Q

Which type of laxative is least recommended?

A

Stimulants

95
Q

What type of laxative should be avoided if you suspect obstruction or impaction?

A

Stimulants

96
Q

What endocrine disorder can sometimes make you think that a patient is depressed?

A

Hypothyroidism

97
Q

How can we screen for hypothyroidism, how often should we do it, and when should we start?

A
  • TSH levels
  • Every 5 years
  • Starting at age 50, or if the patient develops a complaint that could be caused by thyroid disease
98
Q

How often will Medicare pay for a BMD screening?

A

Every 2 years

99
Q

Ototoxic drugs

A
  • Aminoglycosides
  • Antimalarials
  • Antineoplastics
  • Salicylates
  • Loop diuretics
100
Q

Ototoxic drugs that cause reversible damage

A
  • Antimalarials
  • ASA
  • Loop diuretics
101
Q

Is it common or uncommon for basal cell carcinoma to metastasize?

A

Uncommon

102
Q

MC type of chronic urinary incontinence?

A

Urge incontinence

Clin Med V and VI (5 decks)

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