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LECOM 2nd year 1 credit courses > Geriatrics- self study > Flashcards

Geriatrics- self study Flashcards

1
Q

how much has the percentage of 65+ increased since 1900

A

tripled

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2
Q

how old can persons born in 2013 expect to live to

A

78.8

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3
Q

what population experienced larger % increase than the total population

A

centenarian

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4
Q

what is the major income source in older adults

A

social security

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5
Q

how much of the 65+ population is below poverty line

A

4.2 million (9.5%)

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6
Q

who has the highest poverty rates in 65+ population

A

older hispanic women living alone

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7
Q

what is the most common chronic condition in older persons

A

HTN

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8
Q

what disability is reported in 25% of reported disability in 65+

A

ambulatory difficulty

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9
Q

what are the activities of daily living (ADLs)

A

bathing, dressing, eating

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10
Q

what are the instrumental activities of daily living (IADLs)

A

shopping, housework, taking meds

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11
Q

what does medicare part A cover

A

hospital care, nursing home care, hospice, home health services

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12
Q

what is the term form biological systems that reorganize and reset points of balance in response to internal and external chain to maintain functional capacity

A

homeodynamics

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13
Q

what is the term described as measure of ability of cells, tissues and organs to operate optimally

A

functional capacity

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14
Q

what is the syndrome of frailty characterized by

A

weakness, weight loss, and low activity

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15
Q

what are the 5 criteria of frailty

A

self reported exhaustion; slowed performance (by walking speed); weakness (by grip strength); unintentional weight loss (10 lb loss); low physical activity

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16
Q

what type of death do cells undergo at low ATP levels

A

necrotic death instead of apoptosis

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17
Q

what cytokine level increases with age as protective against apoptosis

A

IL-6

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18
Q

what is senescence

A

response of normal cells to potentially cancer-causing events

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19
Q

what cyclin-dependent kinase inhibitors are involved in the arrest in senescence

A

p16, p21

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20
Q

what complexes degrade damaged proteins with ubiquitin

A

proteasome

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21
Q

how does autophagy maintain homeostasis

A

through mitochondrial turnover

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22
Q

what is the term described as pro-inflammatory cytokines can act as neuromodulators and mediate depressive disorders

A

cytokine hypothesis of depression

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23
Q

what is the key transcription factor in inflammatory response

A

NF-kB

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24
Q

what is the most effective phase of team formation

A

performing stage

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25
Q

what is the most important think in reducing medical errors

A

effective communication

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26
Q

what issues are teams less effective for

A

depression, palliative care, dementia

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27
Q

what issues are teams more effective for

A

those with specific diagnoses or syndromes (hip fractures, delirium)

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28
Q

what does ACE stand for

A

acute care for elderly

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29
Q

what is the focus of ACE

A

fostering independence and maintaining cognitive and physical function

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30
Q

what is the setting of syndrome specific model

A

hospital setting

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31
Q

what is the focus of syndrome specific model

A

target conditions to begin comprehensive improvement of geriatric care

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32
Q

who does the GEM unit accept

A

patients hospitalized in other units who are experiencing geriatric syndromes (falls, functional decline, etc)

33
Q

what number of drugs significantly increase the risk of falls

A

4+

34
Q

what anticholinergic antiarrythmics as first line treatment for atrial fibrillation can be potentially inappropriate

A

amiodarone, dronedarone, disopyramide, digoxin

35
Q

how long can proton pump inhibitors be used before they may be considered inappropriate for elderly

A

8 weeks (more than 8= potentially inappropriate)

36
Q

what is the leading cause of fatal and nonfatal injuries in 65+

A

falls

37
Q

what is a person at increased risk for with intense vitamin D supplementation

A

increased kidney stone risk

38
Q

what are some intrinsic risk factors for pressure ulcers

A

limited mobility, poor nutrition, comorbidities, aging skin

39
Q

what are some extrinsic risk factors for pressure ulcers

A

pressure from hard surface, friction, shear forces, moisture

40
Q

what is the most commonly used tool for predicting risk

A

braden scale

41
Q

what stage of pressure ulcer is described as intact skin with non-glancing redness

A

stage 1

42
Q

what stage of pressure ulcer is described as shallow open ulcer with red-pink wound bed

A

stage 2

43
Q

what stage of pressure ulcer is described as full-thickness tissue loss with visible subcutaneous fat

A

stage 3

44
Q

what stage of pressure ulcer is described as full-thickness tissue loss with exposed muscle and bone

A

stage 4

45
Q

what stage of pressure ulcer is described as full-thickness tissue loss with base covered by slough

A

unstageable

46
Q

how often should bedridden patients be repositioned to reduce risk of pressure ulcers

A

every 2 hours

47
Q

what degree is the upper limit that the head of the bed should be elevated to minimize shear

A

30 degrees

48
Q

what is the most prevalent complication of ulcers

A

systemic infections

49
Q

what should empirical antibiotics for systemic infections cover

A

MRSA, anaerobes, and gram negatives (pseudomonas)

50
Q

how do long hospital stays effect decline in function

A

longer hospital stays lead to further decline in function

51
Q

what is the term for interaction between daily behaviors needed to maintain life (ADLs) and physical, cognitive, and social functioning level

A

functional status

52
Q

what is the goal of HARP (hospital admission risk profile)

A

identify patients in need of comprehensive discharge plans, geriatrics assessment, and post-hospital rehabilitation

53
Q

what is the term for acute disorder of attention and cognition

A

delirium

54
Q

what do geriatrics units help prevent

A

patients from losing functional capacity

55
Q

what 6 delirium factors does hospital elder life program (HELP) target

A

cognitive impairment, visual/hearing impairment, immobilization, psychoactive medication use, dehydration, sleep deprivation

56
Q

what elements are evaluated in geriatric assessment

A

nutriton, vision, hearing, continence, balance

57
Q

what scale is used for ADL

A

Katz ADL scale

58
Q

what scale is used for IADL

A

lawton IADL scale

59
Q

what are the most common causes of visual impairments in elderly

A

glaucoma, diabetic retinopathy, cataracts, ARMD

60
Q

what is continence often a key deciding factor in

A

nursing home placement

61
Q

what assessments should be included for evaluation of continence

A

fluid intake evaluation, medications, cognitive function, mobility and urological surgeries

62
Q

what evaluations are used to assess for fall risk with balance and fall prevention

A

Tinoetti balance and gait evaluation

63
Q

what age for women is routine screening for osteoporosis recommended

A

65+

64
Q

what criteria is used to evaluated polypharmacy

A

Beers criteria

65
Q

what non-opioid analgesic is well tolerated in normal renal and hepatic function in the elderly

A

acetaminophen

66
Q

why should NSAIDs be avoided for persistent pain in elderly

A

long-term use is associated with GI bleeding and renal dysfunction

67
Q

what is a safer alternative to NSAIDs in elderly, but is also associated with increased cardiovascular risks

A

selective COX-2 inhibitors

68
Q

what are frequent adverse reactions seen in elderly with propoxyphene

A

ataxia, dizziness, neuroexcitatory effects

69
Q

what are frequent adverse reactions seen in elderly with meperidine hydrochloride

A

nephrotoxic metabolites

70
Q

what are frequent adverse reactions seen in elderly with methadone hydrochloride

A

long and variable half life

71
Q

what are frequent adverse reactions seen in elderly with tramadol hydrochloride

A

dizziness and reduced seizure threshold

72
Q

what is the term described as interdisciplinary care that focuses on improving quality of life for persons of any age who are living with serious illness

A

palliative care

73
Q

what is the current qualification for hospice care

A

prognosis of survival of 6 months or less and are willing to forego curative treatment

74
Q

what is the protocol for delivering bad news to older adults at the end of life

A

SPIKES

75
Q

what does SPIKES stand for

A

setting up interview; assessing patient’s perception; obtaining patient’s invitation; giving knowledge; responding to emotion; summarizing discussion

76
Q

what is the standard for effective communication when address older adults at the end of life

A

NURSE

77
Q

what does NURSE stand for

A

naming, understanding, respecting, supporting, exploring

78
Q

what is the most common setting for non-hospice palliative care

A

acute care in home-based settings

79
Q

true or false: dentures are covered by medicare

A

false

LECOM 2nd year 1 credit courses (2 decks)

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