Lecture 7 Flashcards
What are the 3 features of an atypical presentation?
- Vague presentation
- Altered
- Non-presentation of illness (underreporting)
At what age do atypical presentations really start to appear?
> 85yo
What are the atypical symptoms of ACS?
- Dyspnea
- Mild pain to no pain
- New-onset fatigue, dizziness, or confusion
- Predominant GI symptoms
What is the MC symptom in ACS pts older than 80?
Dyspnea
What is the gold standard lab test for diagnosing STEMI?
Troponins I and T.
How does treatment for an older pt with ACS differ from a younger pt?
It does not.
Same treatment, but much closer monitoring.
What is the MC causative organism for CAP and the tx?
- Strep pneumo
- Amoxicillin, Augmentin, cephalosporins
What pneumonia variant should we wary about with elderly?
Aspiration pneumonia
What is the CURB-65 criteria?
- Confusion (new onset)
- Urea (>= 19mg/dL or 7 mmol/L)
- Respiratory rate (>30)
- Blood Pressure (< 90 SBP or <= 60 DBP)
- Older than 65
2 puts you into moderate risk
What is apathetic thyrotoxicosis?
Apathy and depression that is a result of hyperthyroidism
Often presents with cardiac disease
How does apathetic thyrotoxicosis often present in geriatric patients?
- Apathy and depression are the cardinal symptoms.
- Fatigue and slowing down in chronic
- Cardiac disease often present
- Weakness of proximal muscles
- Thyroxine is usually NORMAL
How does subclinical hypothyroidism present in geriatric patients?
- Confusion, agitation, reduced cognitive function
- Increased IOP
- Increased LDL
What are the MCC of acute abdominal pain in older adults?
- Cholecystitis
- Bowel obstruction
- Diverticular disease
- Complications of cancer
- Medication side effects
How does acute abdomen pain typically present in elderly patients?
- Diffuse/no pain
- Lack fever sometimes
- May lack leukocytosis
- Reduced rebound tenderness
What is the MC fluid and lyte problem in elderly pts?
- Dehydration.
- Decreases in body water
- Alterations in thirst perceptions
- Reduced renal function
