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Geriatrics > Midterm Review > Flashcards

Midterm Review Flashcards

1
Q

percentage of older pop in US

A

16.8%

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2
Q

country with the longest life expectancy

A

Japan

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3
Q

most older adults live in…

A

the community (then nursing homes, then assisted living)

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4
Q

what are some impacts of aging pop in the country

A

1 - higher old-age dependency ratio
2 - increased govt spending on healthcare
3 - higher taxes
4 - worker shortage
5 - changing sectors within economy
6 - reduced capital investment

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5
Q

factors associated with aging population (4

A

1 - fertility rate is declining
2 - size of birth is stable
3 - life expectancy is increased
4 - mortality rate is decreased

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6
Q

educational attainment has ______ in people over 65

A

increased

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7
Q

what is the purpose of death certificates

A

1 - proof for insurance
2 - obtain a burial permit
3 - determine cause of death in court
4 - provide info to calculate mortality rate in studies

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8
Q

what happens to the percent of people working in a particular age group as you age

A

it decreases (more young-middle aged people work than older adults)

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9
Q

after 1990, there was an ______ in the percent of people working in the 65-69 age group

A

increase (people are starting to work more in to their later years)

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10
Q

antidepressants side effects (6)

A

FALL RISK (tricyclic… this is why we dont like tricyclic)
nausea
sleep changes
tremor
fatigue
dizziness (SSRIs)

“no sleep for the dedicated”

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11
Q

what do calcium channel blockers do

A

dilate blood vessels which reduces the pressure of blood flowing through them

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12
Q

side effect of calcium channel blockers

A

hypotension (reflex tachycardia)

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13
Q

2 kinds of calcium channel blockers

A

dihydropyridines
non-dihydropyridines

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14
Q

DHP _____ HR at rest and exercise while NDHP _______ HR at rest and exercise

A

increases
decreases
*DHP better for active people

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15
Q

calcium channel blockers suffix

A

-pine

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16
Q

beta blocker effects (3)

A

decrease HR and BP by 20-30%, decreased cardiac output and blood flow

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17
Q

beta blocker side effects (2)

A

bradycardia
hypotension

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18
Q

beta blocker suffix

A
  • lol
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19
Q

PT considerations for beta and calcium channel blockers

A
  • exercise at the same time each day
  • HR should be 40-75% of Karvonen’s formula
  • RPE only an adjunct to HR
  • pt should carry nitroglycerine
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20
Q

in general, do beta blockers increase or decrease exercise tolerance. why

A

decrease b/c HR cannot increase

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21
Q

what are diuretics used for

A

hypertension
edema
heart failure

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22
Q

side effects of diuretics

A

dehydration

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23
Q

PT consideration for a pt taking diuretics

A

do not schedule PT 1-4 hours after closing

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24
Q

side effects of NSAIDs (4)

A

GI bleeding
renal impairment
increased BP
negates cardioprotective benefit of aspirin

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25
Q

side effect of antiplatelets and anticoagulants

A

increased risk of bleeding and bruising

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26
Q

older persons may need _______ time to stabilize body temp. how may this impact PT

A

more
*longer warm up and cool down

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27
Q

it takes older person’s longer to reach ______ during and after exercise

A

homeostasis
*they may need to sit for a few minutes before leaving

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28
Q

T or F: blood supply in older adults may be insufficient when exercising

A

T: may need to monitor their O2 levels

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29
Q

Pts with cardiovascular pathologies should avoid the _______ maneuver

A

valsalva

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30
Q

what is useful to evaluate exercise tolerance

A

RPE

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31
Q

2 overall factors that control human aging

A

1 - environmental (65%)
2 - genetics (35%)

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32
Q

what does an active lifestyle do in relation to aging

A

it helps you build a physiologic reserve to prolong feeling the decline of normal aging

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33
Q

what are some factors associated with age related decline

A
  • physical inactivity (primary)
  • inadequate nutrient intake
  • excess body weight
  • smoking
  • excess alcohol

Eat PIES

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34
Q

how does the physical stress theory explain aging

A

tissues are able to tolerate and adapt to environment changes more in successful aging compared to non-successful aging. better maintenance of homeostasis

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35
Q

as you age, lean mass ______ and fat mass ______

A

decreases
increases

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36
Q

which type of muscle do older adults lose more

A

type 2

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37
Q

where is most of the fat mass increase in aging

A

peritoneum

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38
Q

bone mass _______ with aging starting in the _____ decade

A

decreases
3rd

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39
Q

after menopause, what is a major concern in women

A

bone mass

40
Q

as you age, heart weight, left ventricle wall thickness, left atrium size, and arterial stiffness

A

increases

41
Q

what happens to HR and VO2 max as you age

A

decreases

42
Q

you lose cells from the ______ node as you age which leads to reduced contractility

A

SA

43
Q

residual volume ______ as you age and tidal volume _______

A

increases
remains constant
*all other pulmonary decreases

44
Q

your liver size, hepatic blood flow, and drug metabolism _____ as you age

A

decreases

45
Q

T or F: as you age routine liver chemistries become abnormal

A

F: they are normal

46
Q

renal mass, hepatic blood flow and drug metabolism ______as you age

A

decrease

47
Q

residual urine and reflux into ureters _______ as you age

A

increase

48
Q

what happens to the female reproductive system asyou age

A
  • atrophy and fibrosis of cervical and uterine walls
  • decreased vaginal elasticity
  • decreased hormones and oocytes
  • involution of mammary gland tissue
49
Q

what happens in the male reproductive system as you age

A
  • decreased seminiferous tubules
  • proliferation of stromal and glandular tissue
50
Q

response time _______ as you age

A

increases … basically older adults respond slower

51
Q

T or F: you have decreased nerve cells and blood flow to nerves as you age

A

T

52
Q

as you age, hair cells, otoconia, and vestibular nerve fibers

A

decreases

53
Q

T or F: as you age, you lose visual acuity, depth perception, and contrast sensitivity

A

T

54
Q

what are 3 things that decrease in the somatosensory system as you age

A

1- vibration sense
2- proprioception
3 - sensation

55
Q

you lose hearing from _____ to _____ frequency

A

high to low

56
Q

T or F: cerumen decreases as you age

A

F: it increases

57
Q

T or F: you have decreased olfactory nerves as you age

A

T

58
Q

what taste sensations remain as you age

A

sour and bitter

59
Q

systemic painc omes on ______ while MSK pain is….

A

suddenly
sudden or gradual

60
Q

how is systemic pain usually described? what about MSK?

A

systemic = knifing/throbbing
MSK = achy/cramping

61
Q

is MSK pain usually unilateral or bilateral

A

unilateral
*systemic can be either

62
Q

T or F: systemic pain is usually constant

A

T
*MSK pain can usually be relieved by change in position or movement

63
Q

T or F: MSK pain usually has associated signs such as fever or chills

A

F: but systemic does

64
Q

s/s of CVD

A
  • angina
  • palpitations
  • dyspnea
  • cardiac syncope (faint)
  • cough
  • cyanosis
  • edema
  • caudication
  • fatigue
65
Q

your pt with s/s consistent with intermittent claudication has pain upright on the LE bike. you have them lean forward and the pain goes away. is this intermittent cluadication vascular or neurogenic?

A

neurogenic
*if the pain did not go away it is vascular

66
Q

ABI readings

A

1-1.3 = normal
0.8-0.9 = mild PAD
0.5-<0.8 = mod PAD
<0.5 = severe PAD, critical limb ischemia
<0.2 = ischemic or gangrene

67
Q

s/s of pulmonary disease (5)

A

1) cough
2) dyspnea
3) cyanosis
4) clubbing
5) altered breathing

68
Q

signs of osteoporosis (7)

A

-back pain
-compression/bone fx
-decres height
-kyphosis
-Dowager’s hump
-decrs activity tolerance
-early satiety

69
Q

Paget’s disease clinical signs

A

-back pain
-compression/bone fx
-decres height
-kyphosis
-Dowager’s hump
-decrs activity tolerance
-early satiety

70
Q

how to screen for a skin problem

A

A = asymmetry
B = border
C = color
D = diameter
E = evolving

71
Q

red flags for cancer

A

CAUTIONS
-changes in bowel or bladder
-a sore that does not heal in 6 weeks
-unusual bleeding or discharge
-thickening or lump in breast or elsewhere
-indigestion or difficulty swallowing
-obvious change in a wart or mole
-nagging cough or hoarseness
-supplemental signs and symptoms

72
Q

With pts who are hearing impaired, speak ___ not _______

A

slower not louder

73
Q

presbycusis

A

age related hearing loss

74
Q

Is presbycusis sensorineural or conductive? Bilateral or unilateral?

A

sensorineural
bilateral

75
Q

T or F: you lose auditory neurons as you age

A

T

76
Q

conductive hearing loss affects what part of the ear

A

outer and/or middle

77
Q

what can cause conductive hearing loss (3)

A
  • excessive ear wax
  • malformation of pinna/ear canal
  • middle ear infection
78
Q

what is sensorineural hearing loss

A

hearing loss caused when inner ear (cochlea) and/or auditory nerve are affected

79
Q

cut off score for STEADI algorithm

A

4 points or more OR answers yes to:
-fallen in past year
-fear of falling
-feel unsteady standing or walking
*if this is the case they should be screened for falls

80
Q

cutoff score for tug

A

12 sec

81
Q

30 second chair stand cut offs

A

men <12
women <11
*for age 65-69
<7 and <4 for 90-95

82
Q

4 stage balance test cut off

A

there aren’t cut off scores for this one, if you can’t do 1-2 (feet together, staggered, tandem) then they are at an increased risk of falls
*goal is to maintain each position for 10 seconds

83
Q

________ intelligence increases with aging and _______ intelligence declines after early adulthood

A

crystalized
fluid

84
Q

brain volume, weight, grey matter, white matter diffusion, hippocampus volume all _______ with age

A

decrease

85
Q

CSF volume _________ with age

A

increases

86
Q

volume and weight of the brain decline with age at rate of _____% per decade after 40

A

5

87
Q

white matter volume starts to decrease after age _____, grey matter volume starts to decrease after ________ and CSF volume increases after _______

A

50
birth
birth

88
Q

hippocampus is responsible for what? Amygdala?

A

Hippo
- long-term mem
- spatial navigation
Amy
- emotions
-survival instincts
-memory

*they both decrease/lose matter with age

89
Q

what is a cognitively active lifestyle?

A
  • do something that requires brain power
90
Q

symptoms of depression in older adults

A
  • sleep disturbance
  • fatigue
  • psychomotor retardation (childlike behavior)
  • hopelessness about the future
91
Q

tools for depression in older adults?

A
  • Geriatric Depression scale (GDS)
  • PHQ-9
  • PHQ-2
92
Q

PHQ-9

A
  • 9 questions
  • a total score of 27
  • higher score = more depressed
93
Q

Geriatric Depression Scale

A
  • GDS
  • 15 or 30 questions
  • total score out of 15 or 30
  • a score of >5 (short one) and more points is suggestive of depression
94
Q

PHQ-2

A
  • 2 questions
  • total score out of 6
  • cutoff score >3
  • little interest or please in doing things in the past 2 weeks
  • feeling down, depressed, or hopeless in the past 2 weeks
95
Q

clues for identifying depression in older adults

A
  • unexplained somatic complaints
  • hopelessness
  • helplessness
  • anxiety and worries
  • loss of feeling (pleasure)
  • slowed movement
  • irritability
  • lack of interest in personal care

Geriatrics (6 decks)

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