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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
side effect of antiplatelets and anticoagulants
increased risk of bleeding and bruising
26
older persons may need _______ time to stabilize body temp. how may this impact PT
more *longer warm up and cool down
27
it takes older person's longer to reach ______ during and after exercise
homeostasis *they may need to sit for a few minutes before leaving
28
T or F: blood supply in older adults may be insufficient when exercising
T: may need to monitor their O2 levels
29
Pts with cardiovascular pathologies should avoid the _______ maneuver
valsalva
30
what is useful to evaluate exercise tolerance
RPE
31
2 overall factors that control human aging
1 - environmental (65%) 2 - genetics (35%)
32
what does an active lifestyle do in relation to aging
it helps you build a physiologic reserve to prolong feeling the decline of normal aging
33
what are some factors associated with age related decline
- physical inactivity (primary) - inadequate nutrient intake - excess body weight - smoking - excess alcohol *Eat PIES*
34
how does the physical stress theory explain aging
tissues are able to tolerate and adapt to environment changes more in successful aging compared to non-successful aging. better maintenance of homeostasis
35
as you age, lean mass ______ and fat mass ______
decreases increases
36
which type of muscle do older adults lose more
type 2
37
where is most of the fat mass increase in aging
peritoneum
38
bone mass _______ with aging starting in the _____ decade
decreases 3rd
39
after menopause, what is a major concern in women
bone mass
40
as you age, heart weight, left ventricle wall thickness, left atrium size, and arterial stiffness
increases
41
what happens to HR and VO2 max as you age
decreases
42
you lose cells from the ______ node as you age which leads to reduced contractility
SA
43
residual volume ______ as you age and tidal volume _______
increases remains constant *all other pulmonary decreases
44
your liver size, hepatic blood flow, and drug metabolism _____ as you age
decreases
45
T or F: as you age routine liver chemistries become abnormal
F: they are normal
46
renal mass, hepatic blood flow and drug metabolism ______as you age
decrease
47
residual urine and reflux into ureters _______ as you age
increase
48
what happens to the female reproductive system asyou age
- atrophy and fibrosis of cervical and uterine walls - decreased vaginal elasticity - decreased hormones and oocytes - involution of mammary gland tissue
49
what happens in the male reproductive system as you age
- decreased seminiferous tubules - proliferation of stromal and glandular tissue
50
response time _______ as you age
increases ... basically older adults respond slower
51
T or F: you have decreased nerve cells and blood flow to nerves as you age
T
52
as you age, hair cells, otoconia, and vestibular nerve fibers
decreases
53
T or F: as you age, you lose visual acuity, depth perception, and contrast sensitivity
T
54
what are 3 things that decrease in the somatosensory system as you age
1- vibration sense 2- proprioception 3 - sensation
55
you lose hearing from _____ to _____ frequency
high to low
56
T or F: cerumen decreases as you age
F: it increases
57
T or F: you have decreased olfactory nerves as you age
T
58
what taste sensations remain as you age
sour and bitter
59
systemic painc omes on ______ while MSK pain is....
suddenly sudden or gradual
60
how is systemic pain usually described? what about MSK?
systemic = knifing/throbbing MSK = achy/cramping
61
is MSK pain usually unilateral or bilateral
unilateral *systemic can be either
62
T or F: systemic pain is usually constant
T *MSK pain can usually be relieved by change in position or movement
63
T or F: MSK pain usually has associated signs such as fever or chills
F: but systemic does
64
s/s of CVD
- angina - palpitations - dyspnea - cardiac syncope (faint) - cough - cyanosis - edema - caudication - fatigue
65
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?
neurogenic *if the pain did not go away it is vascular
66
ABI readings
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
s/s of pulmonary disease (5)
1) cough 2) dyspnea 3) cyanosis 4) clubbing 5) altered breathing
68
signs of osteoporosis (7)
-back pain -compression/bone fx -decres height -kyphosis -Dowager's hump -decrs activity tolerance -early satiety
69
Paget's disease clinical signs
-back pain -compression/bone fx -decres height -kyphosis -Dowager's hump -decrs activity tolerance -early satiety
70
how to screen for a skin problem
A = asymmetry B = border C = color D = diameter E = evolving
71
red flags for cancer
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
With pts who are hearing impaired, speak ___ not _______
slower not louder
73
presbycusis
age related hearing loss
74
Is presbycusis sensorineural or conductive? Bilateral or unilateral?
sensorineural bilateral
75
T or F: you lose auditory neurons as you age
T
76
conductive hearing loss affects what part of the ear
outer and/or middle
77
what can cause conductive hearing loss (3)
- excessive ear wax - malformation of pinna/ear canal - middle ear infection
78
what is sensorineural hearing loss
hearing loss caused when inner ear (cochlea) and/or auditory nerve are affected
79
cut off score for STEADI algorithm
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
cutoff score for tug
12 sec
81
30 second chair stand cut offs
men <12 women <11 *for age 65-69 <7 and <4 for 90-95
82
4 stage balance test cut off
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
________ intelligence increases with aging and _______ intelligence declines after early adulthood
crystalized fluid
84
brain volume, weight, grey matter, white matter diffusion, hippocampus volume all _______ with age
decrease
85
CSF volume _________ with age
increases
86
volume and weight of the brain decline with age at rate of _____% per decade after 40
5
87
white matter volume starts to decrease after age _____, grey matter volume starts to decrease after ________ and CSF volume increases after _______
50 birth birth
88
hippocampus is responsible for what? Amygdala?
Hippo - long-term mem - spatial navigation Amy - emotions -survival instincts -memory *they both decrease/lose matter with age
89
what is a cognitively active lifestyle?
- do something that requires brain power
90
symptoms of depression in older adults
- sleep disturbance - fatigue - psychomotor retardation (childlike behavior) - hopelessness about the future
91
tools for depression in older adults?
- Geriatric Depression scale (GDS) - PHQ-9 - PHQ-2
92
PHQ-9
- 9 questions - a total score of 27 - higher score = more depressed
93
Geriatric Depression Scale
- 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
PHQ-2
- 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
clues for identifying depression in older adults
- 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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