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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
what is the most important think in reducing medical errors
effective communication
26
what issues are teams less effective for
depression, palliative care, dementia
27
what issues are teams more effective for
those with specific diagnoses or syndromes (hip fractures, delirium)
28
what does ACE stand for
acute care for elderly
29
what is the focus of ACE
fostering independence and maintaining cognitive and physical function
30
what is the setting of syndrome specific model
hospital setting
31
what is the focus of syndrome specific model
target conditions to begin comprehensive improvement of geriatric care
32
who does the GEM unit accept
patients hospitalized in other units who are experiencing geriatric syndromes (falls, functional decline, etc)
33
what number of drugs significantly increase the risk of falls
4+
34
what anticholinergic antiarrythmics as first line treatment for atrial fibrillation can be potentially inappropriate
amiodarone, dronedarone, disopyramide, digoxin
35
how long can proton pump inhibitors be used before they may be considered inappropriate for elderly
8 weeks (more than 8= potentially inappropriate)
36
what is the leading cause of fatal and nonfatal injuries in 65+
falls
37
what is a person at increased risk for with intense vitamin D supplementation
increased kidney stone risk
38
what are some intrinsic risk factors for pressure ulcers
limited mobility, poor nutrition, comorbidities, aging skin
39
what are some extrinsic risk factors for pressure ulcers
pressure from hard surface, friction, shear forces, moisture
40
what is the most commonly used tool for predicting risk
braden scale
41
what stage of pressure ulcer is described as intact skin with non-glancing redness
stage 1
42
what stage of pressure ulcer is described as shallow open ulcer with red-pink wound bed
stage 2
43
what stage of pressure ulcer is described as full-thickness tissue loss with visible subcutaneous fat
stage 3
44
what stage of pressure ulcer is described as full-thickness tissue loss with exposed muscle and bone
stage 4
45
what stage of pressure ulcer is described as full-thickness tissue loss with base covered by slough
unstageable
46
how often should bedridden patients be repositioned to reduce risk of pressure ulcers
every 2 hours
47
what degree is the upper limit that the head of the bed should be elevated to minimize shear
30 degrees
48
what is the most prevalent complication of ulcers
systemic infections
49
what should empirical antibiotics for systemic infections cover
MRSA, anaerobes, and gram negatives (pseudomonas)
50
how do long hospital stays effect decline in function
longer hospital stays lead to further decline in function
51
what is the term for interaction between daily behaviors needed to maintain life (ADLs) and physical, cognitive, and social functioning level
functional status
52
what is the goal of HARP (hospital admission risk profile)
identify patients in need of comprehensive discharge plans, geriatrics assessment, and post-hospital rehabilitation
53
what is the term for acute disorder of attention and cognition
delirium
54
what do geriatrics units help prevent
patients from losing functional capacity
55
what 6 delirium factors does hospital elder life program (HELP) target
cognitive impairment, visual/hearing impairment, immobilization, psychoactive medication use, dehydration, sleep deprivation
56
what elements are evaluated in geriatric assessment
nutriton, vision, hearing, continence, balance
57
what scale is used for ADL
Katz ADL scale
58
what scale is used for IADL
lawton IADL scale
59
what are the most common causes of visual impairments in elderly
glaucoma, diabetic retinopathy, cataracts, ARMD
60
what is continence often a key deciding factor in
nursing home placement
61
what assessments should be included for evaluation of continence
fluid intake evaluation, medications, cognitive function, mobility and urological surgeries
62
what evaluations are used to assess for fall risk with balance and fall prevention
Tinoetti balance and gait evaluation
63
what age for women is routine screening for osteoporosis recommended
65+
64
what criteria is used to evaluated polypharmacy
Beers criteria
65
what non-opioid analgesic is well tolerated in normal renal and hepatic function in the elderly
acetaminophen
66
why should NSAIDs be avoided for persistent pain in elderly
long-term use is associated with GI bleeding and renal dysfunction
67
what is a safer alternative to NSAIDs in elderly, but is also associated with increased cardiovascular risks
selective COX-2 inhibitors
68
what are frequent adverse reactions seen in elderly with propoxyphene
ataxia, dizziness, neuroexcitatory effects
69
what are frequent adverse reactions seen in elderly with meperidine hydrochloride
nephrotoxic metabolites
70
what are frequent adverse reactions seen in elderly with methadone hydrochloride
long and variable half life
71
what are frequent adverse reactions seen in elderly with tramadol hydrochloride
dizziness and reduced seizure threshold
72
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
palliative care
73
what is the current qualification for hospice care
prognosis of survival of 6 months or less and are willing to forego curative treatment
74
what is the protocol for delivering bad news to older adults at the end of life
SPIKES
75
what does SPIKES stand for
setting up interview; assessing patient's perception; obtaining patient's invitation; giving knowledge; responding to emotion; summarizing discussion
76
what is the standard for effective communication when address older adults at the end of life
NURSE
77
what does NURSE stand for
naming, understanding, respecting, supporting, exploring
78
what is the most common setting for non-hospice palliative care
acute care in home-based settings
79
true or false: dentures are covered by medicare
false

LECOM 2nd year 1 credit courses (2 decks)

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