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Geriatrics > Lecture 4 from Profs > Flashcards

Lecture 4 from Profs Flashcards

1
Q

what are age related changes in the epidermis

A

skin more fragile

altered turnover rate & DNA repair; photo-aging

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2
Q

what are age related changes with the dermis?

A

loss of thickness
decrease mast cells and histamine
decrease vascular supply and collagen synthesis

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3
Q

What changes with the SubQ with age?

A 
decreased volume (face and hands)
increase volume in abdomen and thighs
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4
Q

which level of vit d is tested for?

A

25-hydroxycholecalciferol

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5
Q

where do you get Vitamin D?

A

Dairy, fish, sun

must go through a process to be used

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6
Q

why does hair grey?

A

hair follicles produce less melanin

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7
Q

what causes senile purpura?

A

Capillary fragility

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8
Q

why is temp regulation difficult?

A

atrophy of sweat glands

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9
Q

what causes pressure ulcers?

A

decreased SubQ fat

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10
Q

what is dry skin?

A

xerosis

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11
Q

what are purple spots in skin exposed areas? not raised or painful.

A

actinic purpura

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12
Q

what is the name for age spots/ liver spots?

A

solar lentigo

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13
Q

what are waxy, raised lesions?

tan, brown-black, or gray, waxy to verrucoid papules and plaques, stuck-on appearance; benign

A

seborrheic keratosis

use cryosurgery to remove

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14
Q

sun exposed area, crusty, reddened, circular

A

Seborrheic keratosis

do a biopsy, or totally remove can turn into squamous cell

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15
Q

reddish bump, large, a bit irregular. can have a crust on it

A

Squamous cell

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16
Q

Red bump with waxy, with telangiectasia

A

Basal cell carcinoma

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17
Q

what biopsy do you not do with melanoma?

A

shave

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18
Q

perpendicular force to skin surface

A

Pressure

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19
Q

parallel force to skin surface

A

Shearing

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20
Q

4 things for pressure ulcers?

A

Pressure
Friction
Shearing force
moisture

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21
Q

main symptom of arterial dz?

A

claudication

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22
Q

what test do we do to check for peripheral arterial dz?

A

ABI

23
Q

cutaneous vesicular eruption & excruciating pain (burning, knifelike, deep & boring)

A

Herpes Zoster

24
Q

Tx for herpes zoster.

A

Antiretrovirals & analgesia = minimize sequelae (post-herpetic neuralgia)

25
Q

Diagnostics for anemia

A 
CBC w/differential
reticulocyte count
 blood smear
erythrocyte indices
 nutritional status
26
Q

what might be a first sign of anemia?

A

Worsening of angina

27
Q

PE changes in anemia

A

pallor
tachycardia
evidence HF
change in cognitive tests

28
Q

What does high MCV indicate?

A

Megaloblastic- B12 and folate deficiences

29
Q

what does normal MCV indicate?

A

Anemia of chronic dz

early Fe deficiency

30
Q

Low MCV indicates what?

A

Fe deficiency
anemia of chronic dz
sideroblastic

31
Q

what can cause iron deficiency?

A

Dietary or blood loss

32
Q

Will ferritin be low or high with microcytic/ hypochromic anemia?

A

Low ferritin

33
Q

How do you treat microcytic/ hypochromic anemia?

A

Ferrous sulfate 2-3 times a day

34
Q

what is a microcytic/ hypochromic anemia that is congenital and acquired. Associated w/ chronic alcohol abuse, RA, cancer, lead poisoning.

A

Sideroblastic anemia

35
Q

diagnostics for sideroblastic anemia

A

CBC- microcytic, hypocrhomic + ringed sideroblasts
increased iron and transferrin saturation
TIBC normal
ferritin normal

36
Q

how do you treat sideroblastic anemia?

A

trial pyridoxine
transfusion
look for cause

37
Q

what can be a problem with transfusion w/ sideroblastic anemia

A

iron overload

38
Q

what can sideroblastic anemia turn into?

A

myeloblastic leukemia

39
Q

labs with anemia of chronic dz?

A

decrease serum iron
high or normal ferritin
TIBC low

40
Q

how do you manage anemia of chronic dz?

A

treat underlying dz or malignancy
EPO
transfusion

41
Q

Signs of B12 deficiency

A

loss of vibratory and position sense
dementia
neuro-psych

42
Q

how to treat b12 anemia?

A

Supplement, correct nutritional or underlying GI issue

43
Q

labs for B12 deficiency

A

CBC: macrocytic, hyperchromic, hypersegmented neutrophils; BM: megaloblasts; B12 & folate levels

44
Q

causes of folate macrocytic/ megalobalstic anemia

A

chronic alcohol abuse
inadequate dietary intake
drugs- anticonvulsants, triameterene

45
Q

signs of folate deficiency anemia?

A

no neuro symptoms

46
Q

who are vit d deficiency seen in lost

A

bed bound

nursing home patients

47
Q

what vitamins do you worry about ODing on?

A

A D E K

48
Q

: non-palpable ecchymotic areas, no hx anticoagulation, abuse, trauma

A

actinic purpura

49
Q

a small, sharply circumscribed, pigmented macule surrounded by normal appearing skin/melanin pigment, aka “age spot”, spots represent areas of melanin overproduction in the skin from lifetime of chronic sun exposure, benign

A

Lentigo

50
Q

tan, brown-black, or gray, waxy to verrucoid papules and plaques, stuck-on appearance; benign

A

Seborrheic keratoses

51
Q

condition of thick, scaly, or crusty patches of skin, pre-malignant lesion, progression to squamous cell CA

A

Actinic keratosis

52
Q

translucent, “pearly” or “waxy” papule; associated telangiectasia, sometimes central ulceration

A

Basal cell carcinoma

53
Q

a flesh-colored or reddish bump or patch

A

Squamous cell carcinoma

54
Q

4 stages of pressure ulcers

A

Non blanching erythema → dermis → fascia → bone

Geriatrics (18 decks)

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