Geriatrics Epidemiology and Syndromes

Question 1

Fastest rising age population

Answer 1

65 and over

and in that group 85 and over

Question 2

highest cohort of suicide successful

Answer 2

men >65

Question 3

Who is eligible for medicare

Answer 3

over 65
disabled for 24 months
end stage renal disease
ALS

Question 4

ADLS

Answer 4

Dressing
Eating
Ambulating 
Toileting 
Hygeine 

DEATH

Question 5

IADLS

Answer 5

Shopping 
Housekeeping 
Accounting 
Food preparation
Telephone
Transportation

SHAFTT

Question 6

Most common cause of death

Answer 6

heart disease

Question 7

malnutrition

Answer 7

weight loss of over 10% in 6 mos or 5% in 1 month

Question 8

Urge incontinence

Answer 8

Detruser muscle in bladder

-

Question 9

Osteopenia

Answer 9

Bone mineral density at any site >1 but <2.5 standard deviations below young adult standard

t score= young adult standard
z score= peers

Question 10

Osteoporosis

Answer 10

BMD measurement >2.5 standard deviaions below young adult standard w/ or w/o previous fracture

Question 11

Osteoporosis treatment

Answer 11

calcium 1500 mg/day
vitamin d 1000 u/day
bisphosphonate- daily, weekly, monthly, annually

Question 12

Delirium

Answer 12

change in mental status that is temporary, usually caused by inciting condition
1/3 of older pts presenting to ER

1) acute change in mental status and inattention
and
disorganized thinking or altered level of consciousness

manage by having sitter or family staying in room, clocks, glasses, hearing aids, mobilize, haloperidol in necessary

Question 13

Dementia

Answer 13

functional loss and significant decline in cognitive functioning and memory

screen with mini mental, slums, MoCa

IADLs lost before ADL (hygiene first)

Question 14

severe dementia

Answer 14

MMSE <10

Lose toileting, then ambulation, then eating

Question 15

Tx of dementia

Answer 15

cholinesterase inhibitors  (donepezil, rivastigmine, galantamine) for mild to mod dementia
NMDA receptor antagonist (memantine) for mod to severe dementia

Question 16

Depression tx

Answer 16

psychotherapy, ssri, electroconvulsive therapy for major depression, suicide risk, mania

inc dose of SSRI if not feeling better!

Question 17

Pressure ulcer

Answer 17

high risk in older people- local blood supply to skin dec, epithelial layers flatten, subq fat dec, collagen fibers lose elasticity, tolerance to hypoxia decreases

Question 18

Staging pressure ulcers

Answer 18

I- persistent erythema of intact skin
II- partial thickness skin loss involving epidermis and or dermis
III- full thickness skin loss involving subq tissue
IV- full thickness loss with tissue necrosis or damage to muscle, bone

Question 19

Suspected deep tissue injury- depth unknown

Answer 19

purple, maroon localized area of discolored intact skin

Question 20

Complications of pressure ulcer

Answer 20

sepsis, localized infection, cellulitis, osteomyelitis, pain, depression