Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Geriatrics > midterm 1 > Flashcards

midterm 1 Flashcards

1
Q

5 RF for acute MI

A 
SOB (most common complaint)
Fatigue
Weakness
Epigastric pain
Low energy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

8 common sites for ulcers

A 
Occiput
Spine
Sacrum
Ischium 
Heels 
Trochanter
Knee
Ankle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Non-modifiable RF for dementia (4)

A

Age (prevalence of AD doubles every 5 yrs >60)
Family hx
APOE-4 gene
Down Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

4 modifiable RF for dementia

A 
Head trauma 
HTN 
DM 
Smoke 
Depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

word finding issues, apathy/indifference, delusion, disorientation

all specific to

A

AD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

only dementia that is specifically subcortical

A

Parkinson’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

multiple stroke like events put you at risk for what dementia

A

Vascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

fluctuating attention
fidgety
agitated
tremulous or apathetic

are all characteristic of what type of dx

what type of dx material would you see

A

delirium

hx of toxin, infx, or metabolic etiology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

progressive memory deficits are characteristic of

A

AD

could be seen with apraxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

behavioral
personality
language changes seen with apraxic gait

A

Frontotemporal dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

limb rigidity

bradykinesia and potential gait disturbance or intential tremor

A

LBD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

fluctuating attention with gait motor and sleep disturbances

A

lbd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

impulsive, hypersexual characteristic of

A

frontotemporal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Typical age of onset with FTD

A

<60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

hallmark of dementia

A

Loss of recent memory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

early vs late dementia

A

impaired ADLs, subtle language errors, impaired spatial perception

phasia, apraxia, agnosia, inattention, left-right confusion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

risk of SSRI for depression in elderly

how to avoid

A

you run the risk of serotonin syndrome

Check Na in 2 weeks if on other meds that effect ADH (diuretics, NSAIDS, monitor for GIB/NSAID/ASA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

buproprian for tx of depression in elderly

A

No sexual side effects, no weight gain, no GIB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

problems with using TC in elderly

A

anticholinergic, increase HR, orthostasis, monitor EKG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

SPLATT

A 
Symptoms - before/after
Previous falls 
Location of the fall
Activity 
Time of day
Trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Trendelenburg what does it look like and what causes it

A

Drop in pelvis/weight to unaffected side

Cause = hip abductor weakness, eg: gluteus medius minimus piriformis, QL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Gluteus Maximus Lurch

what does it look like and what causes it

A

Backward trunk lurch persists to maintain center of balance

Cause = hip extensor weakness; eg, gluteus maximus

23
Q

Steppage what does it look like and what causes it

A

Excess hip flexion to clear food

Cause = foot drop

24
Q

Ataxic what does it look like and what causes it

A

Unsteady, uncoordinated, wide base, feet thrown out coming down on heel then toes
Cause = injury to cerebellum, sensory deficits of lower limb.

25
Q

Antalagic what does it look like and what causes it

A

Walking with pain

Short stance 2/2 pain.

26
Q

RF for falls

A 
History of falls
Gait deficit
Balance deficit
Strength deficit
Restraints (they fight their restraints and fall)
Arthritis
Uses assistive devices 
Impaired ADLs
Depression
Cognitive impairment 
Postural hypotension
27
Q

nitrates BB CCB and estrogens all have what changed in elderly

A

decreased first pass increased serum concentration

28
Q

furosemide in elderly

A

decreased absorprtion leads to decreased effect

29
Q

digoxin and lithium in elderly

A

decrease in lean madd and body water leads to decrease in volume of distribution

30
Q

diazepam chlordiazepoxide

flurazepam and alprazolam are all at risk for what in elderly

A

increased half life because of decreased CYP metabolism

can cause falls

31
Q

AG vancomycin digoxin and salicylates are all risky in elderly because

A

decrease renal elimination and increased half life

32
Q

cimetidine

A

inhibits cyp and increases risk of ADR of other drugs

33
Q

better benzos for elderly

A

Lorazapam and oxazepam

34
Q

increased risk of ototoxicity due to decreased CrCl with this meds

A

TCA and AG

35
Q

AchE inhibitors

A

can cause liver toxicity
avoid with CYP inhibitors

use Donepezil, rivastigmine, and galantamine instead of tacrine

36
Q

problem with digoxin

A

narrow range

needs renal adj

37
Q

CN damage
ototoxicity
nephrotoxicity all a problem in elderly with this drug class

A

AG

38
Q

4 things to consider when writing precriptions

A

a patient’s life expectancy

(2) the time until benefit from medication
(3) goals of care
(4) treatment targets.

39
Q

factors that increase drug effects

A

Take more drugs than younger people
Prescription errors due to lack of consideration of pharmacokinetics
Multiple physicians treating same pt
Increased usades of OTCs among elderly
Cimetidine CYP450
Pt compliance decreases with the number of drugs
Increase in dosage requirements

40
Q

abnx that require dose adjustments .

A

(Beta lactams and AG)

AG: Kanamycin A.
Amikacin.
Tobramycin.
Dibekacin.
Gentamicin.
bl
Amoxicillin/clavulanic acid#
Imipenem/cilastatin#
Ampicillin/flucloxacillin.
Ampicillin/sulbactam (Sultamicillin)
Ceftazidime/avibactam.
Piperacillin/tazobactam.
41
Q

curare like effects seen with what drugs? what does this lead to

A

AG

respiratory paralysis

Curare-like effects at NMJ → respiratory paralyses but reversible w/ neostigmine

42
Q

What are the considerations when prescribing Analgesic

A

opioid –> CNS depression

Corticosteroids → osteoporosis → fractures

NSAIDS (COX-1 COX-2, selective and non-selective) → renal damage

43
Q

7 sxs of neglect

A 
Pressure ulcers **** 
Weight loss/malnutrition 
Dehydration 
Poor hygiene/elongated toenails 
Depression/Inappropriate attire/disheveled 
Abrasions/lacerations
Failure to seek care in timely fashion
44
Q

5 rextrinsic RF for ulcers

A

Pressure (standard mattress. Wheelchair that is too small or too large. Wheelchair seating)
Shearing forces (rubbing from diaper change)
Friction (rubbing heels in bed)
Moisture (diaphoresis caused by pyrexia, autonomic instability)
Urinary/fecal incontinence

45
Q

7 intrinsic RF for ulcers

A 
Nutritional statu
 Age
 Immobility or limited activity
Sensory impairment
Neuropathy (think individuals with DM)
Paraplegics 
Incontinence (fecal > urinary)
This is why we see ulcers on sacrum and coccyx 
Dry skin
Obesity 
Body temp, Blood pressure?
46
Q

4 medical RF for ulcers

A 
Dm
Kidney failure
PVD 
Dzs that require prednisone (thins)
RA
COPD
47
Q

how to prevent ulcers

A

Turn the patient every 2 hours!!!
Although bed rails are a form of restraint, benefits may exceed the risks of restraint injuries
Keep the patient dry
Use special beds to prevent pressure ulcers

48
Q

how to treat ulcers

A

REMOVE PRESSURE
Medical Treatment
Nutrition: High Protein, Vitamin C, Zinc
Monitor albumin and prealbumin/ nutritional consult
Treat primary medical condition/comorbidity
Manage incontinence
Specialized beds and mattresses (air loss and air fluidized mattresses), doughnut cushion
Local wound care
Surgery
Pain management

49
Q

factors to consider in writing rx for elderly

A

“Start low and go slow” Begin at 1/2 the usual adult dose and titrate to the desired effect.

Prescribe the fewest drugs possible and use the simplest dosing regimen.

Patient instruction and education about dose and dosing schedule require more time than expected.

Keep cost in mind. Work with patient’s on fixed income and limited or no insurance.

Review patient’s drug list periodically. Have patient bring all drugs. OTC and herbal medicines to office once a year.

Provide patient with a portable prescription record to take to other physicians. This helps avoid drug-drug ADRs and duplication.

Make home health nurses and aides aware of your need to know about any ADRs observed in your patient.

50
Q

3 Gait changes with advanced age

A

Decline in gait speed
Stride length diminishes
Not due to decrease in cadence

51
Q

Characteristics of gait abnormalities

A

Shorter, broad strides
Longer stance
Shorter swing duration

52
Q

Common Dx leading to Gait disorder

A

Degenerative Joint Disease → #1 reason

Sensory Impairment

Neurological Diseases

Stroke

Parkinson’s

Postural Hypotension/Rx induced

Fear of Falling

53
Q

heel hits ground first as trunch arches back

A

Gluteus Maximus Lurch

54
Q

foot falls flat on floor

A

Steppage gait

Geriatrics (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions