LC 3.2 Changes in Structure and Function with Age

Question 1

<p>What happens to organs as you age? </p>

Answer 1

<p>They decrease in size, apart from the heart which gets bigger</p>

Question 2

<p>When does ageing begin?</p>

Answer 2

<p>30</p>

Question 3

<p>What main factors contribute to ageing?</p>

Answer 3

<p>Genetics
Cell damage
Lifestyle
Disease</p>

Question 4

<p>What structural changes are seen in lungs due to ageing?</p>

Answer 4

<p>Reduced elastic recoil
Increased wall stiffness
Reduced respiratory muscle strength
Reduced intervertebral space
Reduced surface area
Reduced pulmonary capillary volume</p>

Question 5

<p>What ventilatory control changes are seen due to ageing?</p>

Answer 5

<p>Reduced responsiveness to hypoxia/hypercapnia

| Reduced protective reflexes in the airways</p>

Question 6

<p>For which prognostic score for pneumonia is age a factor?</p>

Answer 6

<p>CURB 65

~~~
(Not important - context:
Used to estimate prognosis of pneumonia patient based on:
Confusion
Urea increase
Respiratory rate
BP
Age >65
~~~

Score from 0 to 5 given, one for each factor - 5 is worst)</p>

Question 7

<p>What changes in blood pressure are seen with age?</p>

Answer 7

<p>Increase in PREDOMINANTLY SYSTOLIC blood pressure</p>

Question 8

<p>What causes blood pressure changes with age?</p>

Answer 8

<p>The larger elastic artery walls become thicker and stiffer with age</p>

Question 9

<p>What happens to the heart structurally with age and why?</p>

Answer 9

<p>Left ventricular enlargement due to pumping against high pressure</p>

Question 10

<p>What changes are seen in cardiac function with age?</p>

Answer 10

<p>Decreased beta adrenergic stimulation
Ejection fraction remains the same at rest
Decrease in HR &amp;amp; CO response to exercise or stress</p>

Question 11

<p>What conditions of baroreceptors/heart rate reflexes exist?</p>

Answer 11

<p>Postural hypotension

Carotid sinus syndrome - carotid bodies begin to respond to external pressure as well as internal pressure so that turning of the head or shaving can lower heart rate and vasodilate to reduce flow to the brain via cerebral auto-regulation</p>

Question 12

<p>what is the treatment for carotid sinus syndrome?</p>

Answer 12

<p>pacemaker</p>

Question 13

<p>What GI changes occur with age?</p>

Answer 13

<p>reduced taste buds
reduced saliva
reduced stomach HCl production
reduced gut motility</p>

Question 14

<p>What common dietary problems occur with age?</p>

Answer 14

<p>malnutrition and deficiencies (not due to poor absorption but actually due to reduced intake)</p>

Question 15

<p>What changes in glucose homeostasis occur with age?</p>

Answer 15

<p>Insulin resistance, causing higher and longer peak of blood glucose after a glucose load</p>

Question 16

<p>What changes occur in osmoregulation with age? What does this lead to?</p>

Answer 16

<p>Decreased sensation of thirst due to a poorer response to water deprivation and reduced ability to produce ADH.

Higher risk of dehydration as a result</p>

Question 17

<p>What pharmacokinetic changes are seen with age? What alteration to drugs must be made as a result?</p>

Answer 17

<p>Reduced first pass metabolism due to reduced liver size
Decreased body water distribution volume
Increased fat distribution volume
Increased blood brain barrier permeability
Increased tissue sensitivity
Reduced renal and hepatic clearance

Drug dose must be reduced </p>

Question 18

<p>What changes are seen in the immune system with age? What does this lead to?</p>

Answer 18

<p>Reduction in number and function of T helper lymphocytes
Reduction in size of thymus gland
Reduced B cell antibody production
Less IgE production

more infections</p>

Question 19

<p>What happens to frequency of allergies with age?</p>

Answer 19

<p>Allergies decrease due to loss of immune system function (IgE reduction)</p>

Question 20

<p>What causes shingles?</p>

Answer 20

<p>late reactivation of latent varicella zoster virus (chickenpox)</p>

Question 21

<p>By what order is the risk of shingles increased between the ages of 45 and 85?</p>

Answer 21

<p>5 times</p>

Question 22

<p>What renal changes occur with age?</p>

Answer 22

<p>Reduction in kidney size
reduction in renal blood flow
reduction in glomerular filtration rate
reduced renin &amp;amp; aldosterone levels</p>

Question 23

<p>How is renal function measured?</p>

Answer 23

Serum creatinine used to calculate creatinine clearance using Cockcroft and Gault equation

Question 24

What happens to creatinine levels with age and why?

Answer 24

Stays the same because even though the kidney is clearing less of it, there is less muscle present to produce it

Question 25

What ocular changes occur with age?

Answer 25

pupil size decreases
ciliary muscles weaken (presbyopia)
Lens grows in size and yellows/darkens
lens elasticity decreases
retina and optic pathway cells lost

Question 26

What changes occur in the ears with age?

Answer 26

Degeneration of cochlear cells

loss of high frequency hearing (presbyacusis)

Question 27

How can voice be adapted to help presbyacutic listeners?

Answer 27

deepen voice
slow voice
increase volume

Question 28

What structural changes can be seen with age? What does this help old people adapt against?

Answer 28

ventricle size increases due to decreased cortical volume
Reduced cerebral blood flow
loss of neurones and connections

This is good news in reducing haemorrhage from subdural haemotomas

Question 29

What cognitive changes occur with normal ageing?

Answer 29

memory loss:
working and declarative/episodic memory affected worst
procedural memory affected least

(dementia is abnormal)

Question 30

What happens to the skeletal system with age?

Answer 30

Slow decline in bone mass after 30 years of age

accelerated by menopause in women (osteoporosis)