III: Geriatrics

Question 1

______ accumulates in response to peroxidation of unsaturated fatty acids or membrane lipids

Answer 1

Lipofuscin

Question 2

_______: somatic cells are programmed to die after a finite number of replications

Answer 2

Hayflick limit

Question 3

_____: loss of compensory reserve but otherwise doing ok

Answer 3

Homeostenosis

Question 4

_____: loss of lean body mass that is not considered normal physiology of aging

Answer 4

Sarcopenia

Question 5

Cells deficient in telomerase are restricted at the ____ stage of the cell cycle

Answer 5

G1-S boundary

Question 6

Describe CV changes associated with the dying process (4)

Answer 6

Hypotension, tachycardia progressing to bradycardia, mottling, cyanosis/cooling

Question 7

Describe the mini-cog assessment.

Answer 7

3 item recall and clock drawing

Question 8

In older patients, beta-adrenergic responses ______.

Answer 8

decrease

Question 9

In older patients, functional residual capacity ______.

Answer 9

increases

Question 10

In older patients, pulmonary compliance ______

Answer 10

decreases

Question 11

In older patients, systolic and pulse pressure _____.

Answer 11

increase

Question 12

In older patients, vital capacity ______.

Answer 12

decreases

Question 13

Inhibition of ____ mimics caloric restriction and may promote longevity

Answer 13

mTOR

Question 14

Name 4 physical exam signs relevant to pronoucing death.

Answer 14

Non-responsive, No pulse, No respirations, Absent cranial nerve reflexes

Question 15

Name the 6 ADLs.

Answer 15

Bathing, Grooming, Feeding, Transferring, Toileting, Dressing

Question 16

Palliative care or hospice care? Depends on prognosis

Answer 16

Hospice

Question 17

Palliative care or hospice care? Goal is to improve quality of life at the end of life

Answer 17

Hospice

Question 18

Palliative care or hospice care? Specialized medical care team for people with serious illness

Answer 18

Palliative care

Question 19

What is the effect of restricted caloric intake on longevity?

Answer 19

Promotes longevity

Question 20

What is the management for anorexia in the context of dying?

Answer 20

Educate family, oral care

Question 21

What is the most common symptom associated with acute MI in an older patient?

Answer 21

dyspnea

Question 22

What is the most important factor to a dying patient?

Answer 22

Designated decision maker

Question 23

What is the treatment for pain in the context of the dying process?

Answer 23

Opioids

Question 24

Which ADL is typically lost first?

Answer 24

Bathing

Question 25

Which enzyme is lost with differentiation of cells?

Answer 25

Telomerase

Question 26

Which genetic mutation? Enzyme that help synthesize Coenzyme Q; mutation slows down metabolism

Answer 26

Clk-1

Question 27

Which genetic mutation? HDAC that promotes gene silencing and stabilizes rRNA genes

Answer 27

Sir2

Question 28

Which genetic mutation? Inactivates PIP3, which slows down metabolism and promotes longevity

Answer 28

Age-1

Question 29

Which genetic mutation? Receptor mutation that slows down metabolism to promote longevity

Answer 29

IGF Receptor

Question 30

Which genetic mutation? Telomerase disease causing aplastic anemia

Answer 30

TERT

Question 31

Which genetic mutation? Telomerase disease causing bone marrow failure

Answer 31

TERC

Question 32

Which genetic mutation? Telomerase disease causing skin hyperpigmentation, oral leukoplakia, dystrophic nails, bone marrow failure, hepatic fibrosis, pulmonary fibrosis

Answer 32

dyskerin

Question 33

Which syndrome? Mutation in helicase, aging beginning in early 20s with early onset diabetes, osteoporosis, cancer, and heart disease

Answer 33

Werner Syndrome

Question 34

Which syndrome? Mutation in Lamin A leading to genomic instability, rapid aging with death ~age 13

Answer 34

Progeria

Question 35

Which theory? Aging and death are programmed in the same way that early development Is regulated by genes

Answer 35

Clock Theory

Question 36

Which theory? Aging results from accumulation of oxidative damage in tissues and cells over time

Answer 36

Rust Theory