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Second Developmental Exam > Geriatrics Pt.1 > Flashcards

Geriatrics Pt.1 Flashcards

1
Q

What is ageism associated with?

A

Earlier death (7.5 years)
Poorer physical and mental health
Poor health behaviors

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2
Q

What is ageism?

A

Stereotyping, prejudice, and discrimination based on age

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3
Q

What are some words/phrases to avoid to prevent ageism?

A

Avoid using seniors, elderly, senior citizens, the aged, old person, young person
People in older communities are not patients (they are residents)
Don’t use age if not necessary
Don’t describe as frail, weak, vulnerable
Even “positives” likes old and wise, young at heart, or age is just a number

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4
Q

What are some age-positive phrases that can be used to prevent ageism?

A

Older adult or older people
Home for older adults
Use specifics when relevant and necessary, such as adults over 60 or octogenarians
Reference age is by presenting age as relative

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5
Q

What are some ageist imagery to avoid?

A

Trite, negative stock images: clasped wrinkly hands, long figures on park bench, etc that reinforce stereotypes of decline, depression, and dependence
Unrepresentative images: older adults skydiving and other activities that are exceptional

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6
Q

Why do I need to know how to treat geriatrics?

A

No matter the setting, older adults will be present
Elite athletes can be older adults
Pediatrics pts often care for by grandparents
Family members will also become older adults

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7
Q

In 2020, people 65 and over comprised __ % of the population in the US

A

20%
Baby boomers will continue to age

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8
Q

Do men or women have a longer life expectancy? For every 100 ____ between ages 65-74, there are 86 ___

A

Women
Women; men

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9
Q

Where do the majority of older adults age 65+ live in?

A

Community with their spouse

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10
Q

What percent of people age 85+ live in long term care facilities?

A

15%

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11
Q

Do women or men live in more community dwelling alone?

A

Women

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12
Q

A substantial portion of “usual” age-related decline in functional ability represents ______

A

Deconditioning

Most adults do not engage in sufficient PA to derive health benefits
Reversible with lifestyle modification

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13
Q

What 3 things does successful aging include?

A

Low risk of disease and deconditioning
High cognitive and physical function
Active engagement with life

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14
Q

What does Brummell-Smith define optimal aging as?

A

Capacity to function across many domains (physical, functional, cognitive, emotional, social, and spiritual) to one’s satisfaction and in spite of one’s medical conditions.

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15
Q

What is the difference between primary vs secondary aging?

A

Primary is inevitable and affects all systems
Secondary is lifestyle, environment, and disease

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16
Q

What are factors that contribute to healthy aging?

A

PA, lifestyle, sense of purpose, stress management, social networks, family support, and sleep quality

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17
Q

What is the difference between typical and atypical aging?

A

Typical aging includes gradual decline in functioning of body systems

Atypical gains may look like normal aging but is due to underlying disease processes (specifically cognition like Dementia)

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18
Q

What percent of muscle loss per decade is expected after 50?

A

12-15%

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19
Q

Peak bone density is at ___ years. After, there is more bone resorption than depositions, which leads to ____,_____, and _____. Is trabecular bones loss greater than or less than cortical bone loss?

A

30
Osteoporosis, osteopenia, fractures
Greater than

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20
Q

What are some neuromuscular changes that can be expected with aging?

A

Decrease in brain weight/volume, vascular supply, metabolism, nerve conduction/velocity
Increased risk for neurological diseases (stroke, dementia, epilepsy, ALS, Parkinson’s)

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21
Q

What are some Neuro red flags?

A

LOC, confusion, seizures, sudden bowel/bladder incontinence, sudden gait abnormalities

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22
Q

What is the #1 cause of death in the USA?

A

Heart disease

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23
Q

After 20, what percent per decade does VO2max decrease by?

A

10%

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24
Q

What cardiopulmonary changes can be expected with aging?

A

Decreased VO2max, CO, blood vessel elasticity, pacemaker cells, chest wall compliance, lung capacity
Heart cells thicken/become more fibrotic

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25
Q

What are some oral gastrointestinal changes with aging?

A

Decreased saliva production
Increased risk of swallowing difficulty

26
Q

What are some gut gastrointestinal changes with aging?

A

Altered digestive hormones
Decreased stomach motility
Decreased peristalsis

27
Q

What are some overall gastrointestinal changes with aging?

A

Earlier satiety
Impaired olfaction (affects eating)

28
Q

What are typical changes to the visual system as we age?

A

Presbyopia: far sightedness that starts in middle age
Decreased visual acuity (more light and larger text needed)
Hardening and yellowing of lens (difficulty distinguishing colors)

29
Q

What diseases occur that impact visual system as we age?

A

Cataracts: clouding of lens due to protein buildup (70% of adults by 75)
Glaucoma: loss of peripheral vision
Muscular Degeneration: loss of clarity at center of visual field
Retinopathy: damaged blood vessels in eyes

30
Q

What is the largest organ in the body? What percent of the body weight is it?

A

Integumentary
15%

31
Q

What happens to the Integumentary system as we age?

A
  • Decreased dermis and epidermis
  • Fewer blood vessels, oil, and sweat glands (less thermoregulation and hydration)
  • Decreased cell turnover (increased healing time and decreased barrier function)
  • Fewer mast cells (increased risk of infection)
  • Less collagen and elastin (thinner skin, wrinkles)
32
Q

What skin checks need to be done on every patient?

A
  • skin tears
  • pressure injuries
  • can develop in less than 2 hours
33
Q

What are typical changes in cognition due to aging?

A
  • Slower cognitive speed
  • Decreased word finding abilities (verbal retrieval), selective/divided attention, executive cognitive function (decision making, problem solving, planning, sequencing, multitasking)
  • Difficulty with learning new things
34
Q

What parts of cognition should remain stable with aging?

A
  • Long term memory and procedural memory
  • retention of newly learned information (may require more cueing to recall)
  • visual recognition of objects
35
Q

What are atypical cognition changes with age?

A
  • Mood: withdraw from hobbies/socializing & easily confused, suspicious, depressed
  • Visuospatial: getting lost while driving, bumping into things, decreased peripheral vision
  • Memory: inability to recognize people & decreased long term
  • Communication difficulties
36
Q

What percent of people 65-74 have Mild Cognitive Impairment (MCI)? What about 85+?

A

19%
38%

37
Q

What is considered Mild Cognitive Impairment (MCI)?

A
  • Reduction of capabilities of a person compare to their respective age and education level, but does NOT interfere with ADLs
  • Gradual cognitive decline over 6+ mo
  • Inverse relation with education
  • MCI increases risk of Alzheimer’s
38
Q

Dementia describes a collection of symptoms that are caused by disorders affecting the brain —not one specific disease. Dementia affects thinking, behavior, and the _____ __ ________ ________ _____

A

Ability to perform everyday tasks

(Brain function is affected enough to interfere with a person’s normal social or working life)

39
Q

What is the most common type of Dementia?

A

Alzheimer’s

40
Q

What is the diagnostic criteria for dementia?

A

2 or more must be significantly impaired
- memory
- communicate and language
- ability to focus and pay attention
- reasoning and judgement
- visual perception

41
Q

What are other conditions that may present as dementia?

A

Depression, UTI, delirium, medication side effects, vitamin deficiency, alcohol/drug abuse

42
Q

What is the difference between delirium and dementia?

A

Delirium is a sudden change in mental function
Often accompanied by decreased level of consciousness, slurred speech, agitation, hallucinations, emotional lability

43
Q

What are causes of delirium?

A

UTI/infection, dehydration, hospitalization (11-42% of hospitalized older adults), drug interactions

44
Q

What is the most common mental health condition in people age 65+?

A

Depression
- 11-16% of overall older adult population
- 30-44% of elders live in communal living facilities
- Increased rates of depression among lower SES patients
- Biggest contributing factor to depression in this population is loneliness, life events, and transitions

45
Q

What does depression present as?

A
  • Sadness, anxiety, irritability, hopelessness
  • Cognitive problems: concentrate, memory, indecisiveness
  • Low self-esteem, apathy
  • withdrawal from family/friends, hobbies
  • difficulties sleeping
  • weight changes
  • slowed movement
46
Q

What is the PHQ-2 Screen?

A

Screening tool to identify depression
Over the past 2 weeks (rated on not at all, several days, more than 1/2 of the days, nearly everyday):
- Have you ever felt down, depressed, or hopeless?
- Have you felt little interest or pleasure in doing things?
Scoring: add scores (3+ likely MDD so need further evaluation with PHQ-9or etc)

47
Q

What are the most common types of cancer in geriatrics?

A

Breast, lung, prostate, colorectal

48
Q

In the last 30 years, cancer incidence has increased by __% in older adults

A

26%

49
Q

There is ___x increased chance of developing cancer as an older adult than as a younger person

A

11x

50
Q

What are some signs and symptoms of cancer?

A

Constant pain that occurs at night
Weight loss
Fever
Extreme fatigue
BACK PAIN

51
Q

What is the difference between Type I and II Diabetes?

A

Type I often has juvenile onset; pancreas doesn’t produce insulin
Type II generally has middle age onset, pancreas decreases insulin production

52
Q

What are risk factors for type II diabetes?

A

Obesity, family history, high BP, lack of exercise, age 45+, African American/American Indian, Pacific islanders

53
Q

What are complications of diabetes?

A

Diabetic neuropathy
Diabetic retinopathy
Poor wound healing
Increased risk of stroke and some cancers

54
Q

What is the key hallmark of frailty?

A

Decreased physiologic reserve across multiple organ systems leading to identifiable alterations in physical function

Underweight (BMI <18.5): weakness, slow gait, low energy, shrinking, inactivity

Frailness can affect physical, cognitive, and psychological domains

55
Q

What can frailty be predictive of?

A

Falls, hospitalization, death, disability

56
Q

What is the leading cause of long term disability?

A

Strokes
reduce mobility in over half stroke survivors over 65
Risk Factors: age, high BP, diabetes, smoking, high cholesterol, heart disease

57
Q

What is F.A.S.T.?

A

Signs of stroke
Face: numbness or weakness (especially 1 side)
Arm: numbness or weakness (especially 1 side)
Speech: confusion/trouble speaking or understanding
Time

58
Q

What is the primary infection acquired in hospitals or long term care facilities?

A

UTIs

59
Q

UTIs are the most common cause of hospitalization for bacterial infection and is more common in ______ with 10% of 65+ having had one in the last 12 months

A

Women

60
Q

What are signs and symptoms of UTIs?

A

Fever, flank pain, hematuria, change is mental and function status (often mimic dementia), and reporting falling or LoB

61
Q

What is the second leading cause of hospital acquired infection?

A

Pneumonia

Occurs in 8-10% of all hospital admissions
Leads to roughly 50% of all diagnosis of sepsis
Results in a 33% mortality rate

62
Q

What does Pneumonia look like in geriatrics?

A

4x more likely and 5x more likely to be hospitalized
Increased risk of aspiration with age
Decreased immune response
Decreased ability to clear the airway (weaker supportive muscles like diaphragm, intercostals)

Second Developmental Exam (5 decks)

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