Intro to Geriatrics Flashcards
What is the life span @ birth for females?
79 y.o.
What is the life span @ birth for males?
74 y.o.
What is weakness d/t in aging?
- Loss of muscle mass
2. Loss of bone density
What are the “normal” changes of aging a result of?
Gradual loss of homeostatic mechanisms
What two things does the functional performance of an organ in an older person depend on?
- Rate of deterioration
2. Level of performance needed
What is the hallmark of agin?
How an organism performs during EXTERNAL STRESS
How frequently should weight be checked in the elderly?
@ every visit
How often should you check heigh in elderly?
Annually
What is a decrease in height due to in elderly?
- Osteoporosis
2. Arthritis
How should you take BP in the elderly?
in BOTH arms for @ least 30 seconds
why can BP be false overestimated in elderly?
Pseudohypertension: Noncompressibility of thickened, stiff arteries
What must you perform to avoid pseudo hypertension?
Osler’s maneuver: Palpate radial artery while cuff is being inflated to ensure pulse wave actually disappers
Why should you check blood pressure in both arms?
obstructive atherosclerotic vascular dz
What does a respiratory rate >25 breaths/min indicate in elderly?
1st sign of lower respiratory tract infections
What is the cardinal sx of dry eyes?
Tearing
What are elderly @ an increased risk for d/t lens thickening?
Narrow-angle glaucoma
Define presbyopia
Blurred near vision
Define presbycusis
Diminished hearing in old age:
Loss of high pitched sounds
What can basilar rales/crackles be due to in elderly? How do you check?
Atelectasis from decreased use of lungs
Should clear with deep inhalation and cough
What can Kyphoscoliosis cause?
Displacement of apical impulse
How long should you listen to heart sounds?
30 sec-1 min
What increases in elderly in order to maintain CO?
SV
What heart murmur DOES radiate to the carotids?
Aortic valve stenosis
Where can you hear mitral regurgitation the loudest?
@ apex and radiates to axilla
What does hypertrophic cardiomyopathy increase with?
Valsalva maneuver
What are COMMON peripheral vascular system changes, but NOT normal aging changes?
Arterial and venous changes: i.e. atherosclerosis
Who is at an increased risk for AAA?
Back/Abd pain: Male 65+, smoker
What can further worsen respiratory function in the elderly?
Kyphosis from aging
When would you want to perform an anal wink? What is it? What are you testing for?
Sudden Fecal Incontinence: Herniated disc (above S2)
SF visceral reflex:
Afferent= Pudendal nerve
Efferent=S2-S4
What percentage of men does ED and BPH effect?
50%
At what age range do we see cessation of menstrual periods?
45-52
How often should you perform a Pelvic exam + Pap smear?
every 2-3 years until age 65
If the patient lacks hip mobility, what side should they lay on?
Left side
What does palpable ovaries 10 years post-menopause suggest?
CA
Where do we see loss of height occur most frequently?
Trunk: Intravertebral disc thinning
List OA findings
- Hebedern’s Nodes: DIP
2. Bouchrd Nodes: PIP
List RA findings
- Subluxation of MCP’s w/ ulnar deviation (chronic)
- Swan neck deformity
- Boutonnier deformity
Lis the age-related findings in feet
Hallux valgus
Hammer toe
Claw toe
What can toe deformities result from?
- Ill-fitting foot war
- RA
- DM
- Neuro d/o
Who should be referred to podiatry?
ANY patient with a foot disorder
Define Benign Forgetfulness
Difficulty recalling names of people/objects or details of specific events
Define Bell Phenomenon
Reflex upward movement of eyes during closure is sometimes absent
Normal aging change
What is decreased sense of smell due to?
- Decreased olfactory neurons
- Numerous URI’s
- Chronic Rhinitis
What is decreased tase due to?
- Decreased sense of smell
2. Medications that cause dry mouth
Define Sarcopenia
- Decrease in muscle mass
- MCly affect. hand muscles
- Insignificant findings unless there is a decline or change in function (pt has to use chair arms to stand)
What parts of the body do we see vibratory sensory loss?
Feet and Ankles
Neurogenic claudication etiology
Lumbar spinal stenosis
Neurogenic claudication si/s’s
Pain, numbness, weakness during walking
Decreases with sitting
Difficulty initiating walking etiology
- Frontal/subcortical d/o
- Isolated gait initiation failure
- Parkinsons
Truncal instability (sway) etiology
- Hip/Knee Arthritis
2. Cerebellar/Subcortical/Basal Ganglia dysfunction
Step asymmetry etiology
- Focal neuro deficit
- Pain or weakness in one leg
- Unilateral msk deficit
Step discontinuity etiology
- Fear of falling
2. Frontal lobe d/o
Stride with abnormalities etiology
- Cerebellar d/o
- Hip d/o
- Normal pressure hydrocephalus
What test do we use to measure stability?
Romberg
