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Geriatrics > Midterm > Flashcards

Midterm Flashcards

1
Q

What are nutrients specially required in elderly?

A

Vit D (800-2000 IU), Ca++ (1200-1500 mg), and B12

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2
Q

What number of women > 75 are osteoporotic?

A

1/3

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3
Q

Definition of Osteoporotic

A

2.5 Standard deviations below the mean young adult reference population on a DEXA scan of hip/low back

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4
Q

What forms of calcium are best?

What warnings exist with calcium supplementation?

A 
Calcium citrate (cit's in the stomach) 
Dairy: yogurt and lowfat milk

Don’t take more than 500mg at one time

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5
Q

Non-Modifiable risk Factors for OP

A 
Female 
Fair-skinned 
Small-framed or small-boned 
Of European or Asian descent 
Family history of osteoporosis 
Hysterectomy before the age of 40, or early menopause
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6
Q

Best exercise for OP

A 
Axial loading
Walking
Stair stepping
Free weights
Zumba
3x/week for 15-20 minutes
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7
Q

Delirium

A

Acute confusion of a rapid onset lasting a short period of time that is temporary.

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8
Q

Dementia

A 
Chronic confusion gradual loss in memory. (Alzheimer's).    
Unable to carry out ADLs. 
Not curable.
Involves neurofibrillary tangles
Develops over months to years
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9
Q

Depression

A

MC mental health concern among older adults

80% are fully reversed with treatment

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10
Q

Delirium causes

A

I-WATCH-DEATH
Infections, Withdrawal, Acute metabolic, Trauma, CNS pathology, Hypoxia
Deficiencies, Endocrinopathies, Acute Vascular, Toxins/Drugs, Heavy metals

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11
Q

Modifiable Risk factors for OP

A

Avoid or dislike dairy products
Eat meat more than twice a day, on most days
Drink coffee/tea, or other caffeinated beverages more than twice a day
Drink alcohol more than 3 times per week
Drink soda (pop) more than once a day
Participate in walking, running, aerobics etc. less than 3 times a week
Smoke cigars or cigarettes
Take steroid medications

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12
Q

Primary Prevention of OP

A

Counsel pts about diet and physical activity at all ages, to maximize bone density in the third decade of life and slow the rate of bone loss after that.
Most important factor = physical activity!!!!
Get plenty of Vit. D (sun, food & supplements)t

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13
Q

Secondary Prevention of OP

A

Screen all patients: OP checklist

  1. Identify preventable risks
  2. Get baseline bone mineral density test (Dexa scan of the hip is the gold standard)
  3. Design a prevention plan suited to patient’s risk factors
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14
Q

Tertiary prevention of OP

A 
Employ safe chiro. adjusting strategies 
Fall prevention (IMPORTANT!)
Keep patients physically active
Monitor lifestyle and behaviors,
Encouraging healthy dietary choices
Supplementation!!
Sun (caution related to skin cancer!)
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15
Q

of elderly below poverty level in US

A

1/10

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16
Q

Weight loss good or bad?

What about calories?

A

BAD in elderly, leads to death “fat frail” or “obese sarcopenic”

NEVER calorie restrict

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17
Q

Daily recommended of fiber

Sources?

A

30g

9-10 g: Canned beans (e.g: chili or kidney beans)
7-9 g: Popcorn
4-15 g: Hi Fiber cereals (check the label)

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18
Q

Colon Cancer

A

1 in 17 people get colon cancer in the US
• 55,000 deaths/year in US alone
• Almost all colon cancer is in people over 50
• High fat, low fiber diet, & alcohol (low Ca) increase risks

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19
Q

Dietary Balance between

Decreased need for ____?

Greater need for ____?

A

Carbs, proteins, fats

Decreased need for proteins

Greater need for Fiber, vitamins, mineral

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20
Q

Recommended type of weight loss in elderly?

A

Physical Activity
Want nutrient dense diet
Water & Fiber

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21
Q

Areas to assess

A 
Physical Assessment
Functional Assessment 
Cognitive Assessment
Nutritional/Oral Health Assessment
Safety
Others
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22
Q

Functional Assessment tools

A 
Barthel Index
Functional Status Index
Get Up ‘N Go
ADLs
Observation and other useful strategies
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23
Q

Cognitive Assessment Tools

A

Mini Mental Status exam ( Orientation, Registration, Attention/Calculation, Language)
3 item recall
Clock drawing test

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24
Q

Injuries Occur where?
More serious among?
Due to?
Kill who?

A

Home
More serious in older adults
Most often due to falls
Kills even healthy patients

25
Q

How to assess fall risk?

A

Home Safety checklist

26
Q

How much weight loss should worry us?

A

> 10 lbs w/o trying

27
Q

What race has 2x average incidence of disability due to LBP in the US and higher rates of diabetes $$$

A

Native America

28
Q

Uterine fibroids and prostate CA are more prevalent among which race?

A

African American

29
Q

Which ethnicities are at greatest risk for OP?

A

Caucasian (northern European) & Asian

30
Q

What groups might culturally be accustomed to physical touch in greetings or for reassurance?

Who might be less comfortable with physical ‘touchiness’?

A

Mediterranean, middle east same gender

Asian (Japanese, Chinese)

31
Q

What groups have markedly higher incidences of heart disease, HTN, and diabetes

A

Mexican, African American

32
Q

Which ethnicities are more likely to include family in making health decisions?

A

Hispanic

33
Q

What group in the US believes in the concept of “beautiful talk”, feeling that framing health talks in the negative context of disease risk may skew health outcomes negatively?

A

Native American

34
Q

Students of which ethnicitis/cultures would consider it disrespectful to make direct eye contact w/ and instructor, elder, or member of the opposite sex

A

Asian, Middle eastern

35
Q

Over 200 cultural groups believe that this phenomenon (the ________ _____) is responsible for sudden unexplainable onset of illness or disability. In the US we might just think of it as a superstition

A

evil eye

36
Q

Which cultural/religious group in the midwest and rural east coast areas is perhaps the highest utilizer of chiropractor for many 1º healthcare needs?

A

Amish

37
Q

Which ethnic groups (3) would be more likely to believe in the importance of a balance between “hot” and “cold” foods or herbs in their diet?

A

Middle Eastern, Meditteranean, Chinese

38
Q

Aside from race and ethnicity, name other aspects of a patient’s background or life-circumstance that may impact the way they respond to you as a doctor or your care recommendations

A

Socio-economic status
Age
Education
Religion

39
Q

At least one-tenth of the aged are living in long-stay institutions (i.e. nursing homes, mental hospitals, homes for the aged, etc.).
T/F

A

False

40
Q

Aged drivers have fewer accidents than those under 65

T/F

A

True

41
Q

The majority of people are seldom bored. T/F

A

True

42
Q

Over 15% of the US population is now 65 years or older. T/F

A

False

43
Q

Most medical practitioners give low priority to the aged T/F

A

True

44
Q

The majority of older people have incomes below the poverty level T/F

A

False

10% below Poverty level

45
Q

Older people tend to become more religious as they age. T/F

A

False

46
Q

Older persons have more acute (short-term) illness than people under 65 T/F

A

False

47
Q

Social security benefits automatically increase with inflation T/F

A

True

48
Q

Older persons have more injuries in their home than those under 65 T/F

A

False

49
Q

Supplemental Secur. Income guarantees a minimum income for needy aged. T/F

A

True

50
Q

The proportionate of blacks among the elderly is growing T/F

A

True

51
Q

The rate of poverty among aged blacks is 3x higher than whites T/F

A

True

52
Q

About 3% more of the aged have incomes below the official poverty level thanthe rest of the population. T/F

A

False

53
Q

More of the aged vote than any other group T/F

A

False

54
Q

Which drugs are more likely to send people to the ER?

A

Anticoagulants, Diabetes

55
Q

Adverse effects are responsible for __#__ of all ER visits in those over 65

A

1/4

56
Q

Risks associated w/ NSAIDs

What cause do people take multiples

A

2 or more dangerous
GI bleed (even more increased risk with alcohol use)
kidney toxicity

Arthritic pt. 26% use 2 or more

57
Q

How do you best prevent future falls?

A 
Ask what caused previous falls SPLATT
Symptoms
Previous Falls
Location
Activity
Trauma
Time
58
Q

T/F More of the aged vote than any other group

A

False

59
Q

T/F The proportion widowed is decreasing among the aged

A

True

Geriatrics (1 decks)

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