Geriatrics

Question 1

Geriatrics vs. Gerontology

Answer 1

Geriatrics- branch of medicine involving care for the elderly

Gerontology- studying social aspects of aging

Question 2

Describe the ages considered 1. Young old 2. Old old 3. very old (dust)

Answer 2

1. <75
2. <85
3. > 85

Question 3

What accounts for most loss of function in the elderly: age or disorders?

Answer 3

Disorders, although we do go through cellular aging and programmed cell death.

Geriatric population more prone to extreme stress

Question 4

What is included in an annual preventative health visit?

Answer 4

1. Screenings
2. Vaccines
3. BMI
4. Vision test
5. Depression screen
6. Advance Directive talks
7. Plan for health care

Question 5

T/F: The annual preventive health visit vision test includes a retinal exam and evaluation of IOP to screen for Glaucoma

Answer 5

False: very simple snellen eye chart test

Question 6

Recommendation from the United States Preventative Services Task Force (USPSTF) to reduce fall risk

Answer 6

Exercise/PT and Vitamin D supplementation

Question 7

What deficits increase risk of Fall in old people?

Answer 7

Sensory (proprioception)
Cerebral infarcts
Vision/Hearing/Smell impairment
Posture (Kyphosis)

Question 8

What is the Mortality rate for hip fractures within 1 year

Answer 8

14-58%

Question 9

Examples of screening tools to assess Cognitive decline

Answer 9

MiniMental Status Exam

MiniCOG- clock drawing and 3 word recall test

Question 10

2 most common mood disorders in the elderly

Answer 10

Depression

Bipolar Disorder

Question 11

In addition to neurological disorders resulting in incontinence, why else may a geriatric patient be incontinent?

Answer 11

Mobility issues. Can’t get to the bathroom in enough time.

Consider bedside commode, scheduled bathroom visits, exercise

Question 12

What are the privileges of Durable Power of Attorney (DPOA)

Answer 12

Can make medical decisions on behalf of the patient if the patient cannot make them.
Medical DPOA does not always equal Financial DPOA, they can be different people

Question 13

What are Advanced Directives?

Answer 13

Indicate preference of various treatment/care. 
Code status
Ventilator care
tube feedings
Abx

Question 14

What is the most common criteria to use to assess medication use in the elderly?

Answer 14

BEERS criteria

Question 15

4 reasons elderly individuals experience more ADE’s (adverse drug events)

Answer 15

1. Decreased clearance by liver/kidneys
2. Drug-drug interactions
3. Med errors
4. Cost of meds preventing adherence

Question 16

Polypharmacy

Answer 16

multiple medications used by one person

Question 17

BEERS criteria revisions in 2019

Answer 17

1. Avoid opioids with Benzos and gabapentinoids
2. Caution TMP/SMX in ACE/ARB patients- risk of hyperkalemia
3. Avoid H2 antagonists (-tidines) in delirium
4. Avoid SNRI (deluxitine) with hx of fractures
5. Avoid Hypoglycemia (duh!)