Intro to Geriatrics

Question 1

Who is considered geriatric?

Answer 1

65 years and older

Question 2

Hallmark of aging is associated with how an organ performs when?

Answer 2

during external stress (not rest)

Question 3

How often should you check weight?

Answer 3

every visit

Question 4

How often should you check height?

Answer 4

yearly (for osteoporosis)

Question 5

How should you check pulses and BP?

Answer 5

in each arm for 30 seconds

• Check for orthostatic hypotension
• stiff arteries can lead to overly high BP readings (pseudohypertension)

Question 6

What is a change that happens with pupils in old age?

Answer 6

pupils become smaller and may be slightly irregular

-sluggish pupillary light relex

Question 7

PE: chest/back/heart

Answer 7

• apical impulse might displace due to kyphoscoliosis

- sinus bradycardia may not be clinically important

Question 8

Mitrial valve regurgitation

Answer 8

• Loudest at apex

- Radiates to axilla

Question 9

Aortic valve stenosis

Answer 9

-radiates to carotids

Question 10

When are hypertrophic cardiomyopathy murmurs most intense?

Answer 10

with valsalva maneuver

Question 11

At what age are diastolic murmurs significant?

Answer 11

Diastolic murmurs are abnormal at any age

Question 12

Back pain in a male smoker over the age of 65 should raise what concern?

Answer 12

Abdominal aortic aneurysm

Question 13

Since ovaries shouldn’t be palpable within 10 years after menopause, what do palpable ovaries suggest in this time period?

Answer 13

ovarian cancer

Question 14

Where does most loss of height occur in late adulthood?

Answer 14

trunk reflecting intravertebral disc thinning

can also be from collapse of vertebral bodies

Question 15

Herbeden’s nodes

Answer 15

DIPs

Question 16

Bouchard nodes

Answer 16

PIPs

Question 17

Swan-neck deformity and boutonniere deformity are associated with which condition?

Answer 17

RA

Question 18

Name 3 common age-related findings of the feet?

Answer 18

1. Hallux valgus (pointing laterally)
2. Hammer toe
3. Claw toe

Question 19

Bell phenomenon

Answer 19

reflex upward movement of eyes during closure

Question 20

Where in particular is most affected by sarcopenia?

Answer 20

hand muscles

Question 21

It is common for old people to lose vibratory sense where?

Answer 21

feet and ankles

not shins or fingers

Question 22

Which reflexes are commonly decreased or absent?

Answer 22

• gag reflex

- ankle reflexes

Question 23

During a test for gait velocity, how far does the patient walk?

Answer 23

Record # of secs for the 4m in the middle

So: Distance (4m)/sec

Question 24

Normal Gait velocity

Answer 24

> 0.8m/sec

Question 25

Slow gait velocity

Answer 25

<0.8m/sec | predictive of cognitive and physical decline, hospitalization and falls

Question 26

Labs that don't change with age

Answer 26

- Hemoglobin and hematocrit - WBC - platelet - Electrolytes (Na+, bicarbonate, potassium, chloride) - BUN - Liver (ALT, AST, bilirubin, PT) - Thyroid - Calcium/Phosphorus