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Gerontology > Module 3 > Flashcards

Module 3 Flashcards

0
Q

How many of those diagnosed with heart failure are diagnosed for the first time?

A

Over 500,000

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1
Q

Majority of those with heart failure are over the age of —- and hold —– percent of total

A

65, 80%

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2
Q

What is currently the highest cost to Medicare?

A

Heart failure

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3
Q

What are the total direct and indirect costs of heart failure

A

28 billion

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4
Q

—- % of men and —% of women die within — years after being diagnosed with heart failure

A

80%, 70% and 8

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5
Q

Which gender shows the least amount of improvement after the diagnosis of heart failure?

A

Women

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6
Q

Heart failure occurs when

A

The heart is unable to meet the vascular demands of the body

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7
Q

The most common cause of heart failure is

A

Ischemic LV dysfunction

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8
Q

Three important characteristics of those with heart failure

A

Decreased tolerance to exercise, fluid retention in extremities and abdomen and no signs and symptoms of a different cardiac disorder

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9
Q

Dysrhythmia that is a huge (500%) risk factor for stroke

A

A fib

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10
Q

The moist sudden cardiac deaths are due to

A

V-fib

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11
Q

What is the leading cause of morbidity and mortality in the elderly?

A

Coronary artery disease/ischemic heart disease

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12
Q

Nearly _____(frac) over 65 have CAD/IHD

A

2/3

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13
Q

Define CAD

A

Insufficient blood flow to cardiac muscle

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14
Q

What are the symptoms/effects of CAD?

A

Fatigue, dyspnea, limited ability to withstand increased work load on heart, increased response time to activity

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15
Q

2 different names for acute coronary syndrome

A

Acute MI and unstable angina

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16
Q

Major risk factor for acute coronary syndrome?

A

Atherosclerotic buildup in coronary arteries obstructing oxygenated blood flow to cardiac muscle

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17
Q

What is angina?

A

Chest pain due to insufficient oxygen delivery to cardiac muscle

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18
Q

What is stable angina?

A

Occurs only during exercise or stress

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19
Q

What is unstable angina?

A

Unexpected and occurs at rest

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20
Q

How much money was spent on HTN in 2011?

A

94 billion

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21
Q

What is the most prevalent condition in those over 65?

A

HTN

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22
Q

Values for pre hypertension:

A

Systolic: 129-139 diastolic:80-89

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23
Q

Values for stage 1 hypertension mild

A

Systolic: 140-159 and diastolic 90-99

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24
Q

Values for stage 2 hypertension moderate

A

Systolic: 160-179 and diastolic: 100-109

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25
Q

Values for stage 3 hypertension severe

A

Systolic greater than 180 and diastolic greater than 110

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26
Q

The two types of valvular disease

A

Stenosis and insufficiency

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27
Q

What is valvular stenosis?

A

Narrowing of the valve that restricts blood flow

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28
Q

What is valvular insufficiency

A

When the valve does not close completely resulting in backward flow

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29
Q

What are the two other names for valvular insufficiency

A

Regurgitation or leaky valve

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30
Q

What is myocardial degeneration

A

The decline of cardiac performance resulting in slow HR recovery and absence of an increased SBP with exercise

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31
Q

What is peripheral vascular disease

A

Partial or complete obstruction of blood flow in periphery

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32
Q

What is buerger’s disease

A

Thromboangitis obliterans: a highly cellular, segmental and inflammatory occlusive thrombosis

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33
Q

Buerger’s disease presently commonly in…

A

Smokers with distal ischemia

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34
Q

What is arteriosclerosis

A

Hardening of the arteries

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35
Q

What three things happen in arteriosclerosis

A

1 thickening and hardening of the arterial wall 2- accumulation of fat in the intimal lining of the blood vessels 3- increase of connective tissue in the subintima

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36
Q

What is atherosclerosis

A

Type of arteriosclerosis where there is a buildup of plaque in the blood vessels walls which obstructs blood flow in any area of the body

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37
Q

What is the second most common reasons for hospitalization in those over age 65?

A

Pneumonia

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38
Q

What is pneumonia

A

Acute inflammation of the lungs caused by bacterial viral or fungal pathogen

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39
Q

What are the symptoms of pneumonia

A

Rapid shallow breathing, fever, cough and chills

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40
Q

How will NHAP differ from pneumonia

A

More subtle symptoms like confusion or sleep alterations

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41
Q

What is fibrosis

A

The thickening of the alveolar walls as fibroblasts lay down thick collagen bundles

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42
Q

What is COPD

A

Both emphysema and chronic bronchitis

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43
Q

Typical vital signs in those with pneumonia

A

Tachycardia, hypotension, tachypnea, dyspnea, desaturation

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44
Q

Auscultation results on someone with pneumonia

A

Diminished normal breath sounds, rales, low pitched wheezes, bronchial breath sounds

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45
Q

Palpation results on someone with pneumonia

A

Increased tactile fremitus, dull percussion over consolidation, possible decrease in chest wall excursion

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46
Q

Blood has results in someone with pneumonia

A

Decreased PaO2 and possibly altered PaCO2

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47
Q

What would be the observable signs in someone with pneumonia

A

Fever, increased work to breath, facial distress, cyanosis

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48
Q

What is the most common cancer death

A

Lung

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49
Q

Men who smoke are ____ times more likely to get cancer

A

23

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50
Q

Women who smoke are ____ times more likely to get cancer

A

13

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51
Q

What is cor pulmonale

A

Right sided heart failure brought on by long term HTN in pulmonary arteries And RV

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52
Q

Cor pulmonale is present in…

A

End stage lung disease

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53
Q

What is osteoporosis

A

A systemic skeletal disease causing decreased bone mass and deterioration of bone

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54
Q

What three areas are at the greatest risk for fracture in those with osteoporosis

A

Wrist, hip and spine

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55
Q

There are ___ fractures every year in those over 50

A

2 million

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56
Q

Normal t score results

A

-1 to 1

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57
Q

Osteopenic t score results

A

-1 to -2.5

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58
Q

Osteoporotic t score results

A

-2.5 or lower

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59
Q

What is pagers disease

A

When osteoclasts are more active than osteoblasts but then osteoblasts over react and make chaotic excess bone

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60
Q

What are the characteristics of bones in those with pagets disease

A

Irregular mosaic pattern, large, deformed, brittle and weak

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61
Q

Over ____ people have Pagets and it is more common in ______

A

One million, men

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62
Q

What is osteoarthritis

A

Degeneration of articular cartilage and inflammation of synovium with a progressive loss of hyaline cartilage

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63
Q

What feature is common in OA

A

Osteophytes

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64
Q

What are the symptoms of OA

A

Impaired mobility with ADLs, deep ache and joint stiffness with inactivity, loss of flexibility and joint surface congruity

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65
Q

In those with knee OA what is the strongest predictor of pain and deterioration in function ability

A

Quad weakness

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66
Q

What in RA

A

Chronic inflammatory systemic disease effecting the synovium of joints leading to joint damage chronic pain and decreased function

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67
Q

What is stage 1 RA

A

Synovium swelling, warmth, pain, stiffness, erythema and joint effusion

68
Q

What is stage 2 RA

A

Rapid division and growth of cells and thickening of synovium

69
Q

What is stage 3 RA

A

Release of enzymes from inflammatory cells, development of granulation tissue (pannus) causing bone and cartilage destruction and joint malalignment

70
Q

What is delirium

A

A fluctuating attentional state causing temporary confusion and loss of mental function

71
Q

Delirium is present in ___% of adults in acute/ nursing home/SNF

A

70-80

72
Q

Possible causes of delirium

A

Drug toxicity, systemic illness, oxygen deprivation, environmental changes and sensory deprivation

73
Q

What is a screening test for delerium

A

Confusion Assessment Method

74
Q

In dementia patients, they tend to retain ____ memory but have no_____ memory

A

Implicit, explicit

75
Q

By age ___ 1/3 have some form of cognitive impairment

A

85

76
Q

Stages of dementia cover a span of ___ to ____ years and has a _____ pattern

A

8-10 and fluctuating

77
Q

_____ people have AD and this will increase to _____ by 2050

A

5.5 million, 15 million

78
Q

How much in care does AD cost per year

A

60 billion

79
Q

AD will lead to death in ____ years after diagnosis

A

3-9 years

80
Q

2 markers in AD

A

Amyloid clumps and tau protein neurofibrillary tangles

81
Q

2 cerebellar characteristics in AD

A

Atrophy and loss of nerve cells in hippocampus

82
Q

Which chromosomes are of interest in those with AD

A

1,14,19,21

83
Q

Chromosome 1 is the

A

Pre senile gene

84
Q

Chromosome 14 is the

A

Pre senile 2 gene

85
Q

Chromosome 19 is associated with

A

Later onset AD and responsible for cholesterol metabolism

86
Q

Chromosome 21 is responsible for

A

Breakdown of amyloid precursor proteins

87
Q

What is the age risk factor for AD

A

Doubles every 5 years after age 65

88
Q

What is multi infarct dementia

A

Vascular infarct in both gray and white matter of brain

89
Q

Which past medial history component increases changes of multiinfarct dementia

A

Stroke, CVD, HTN

90
Q

What is the distribution of deficits in those with multi infarct dementia

A

Spotty and patchy, areas of impairment with areas of preservation

91
Q

Word that is characteristic of the neuro signs and symptoms associated with multi infarct dementia

A

Focal

92
Q

What emotional aspect is associated with multi infarct dementia

A

Emotional lability ( laugh or cry unexpectedly where it isn’t appropriate)

93
Q

10% of dementia cases are of this type

A

Lewy bodies

94
Q

At what pace does Lewy Bodies dementia progress

A

Gradually

95
Q

Physical symptoms of Lewy bodies

A

Stiffness, rigidity, slow movement patterns, poor balance, fine motor problems, sleep problems

96
Q

Lewy bodies can mimic

A

Parkinson’s

97
Q

Sleep issues in Lewy Bodies

A

Insomnia and nightmares which can lead to depression

98
Q

Does physical abilities in those with Lewy bodies evolve linearly or fluctuate

A

Fluctuate

99
Q

What is the most common cause of disability in the US

A

Stroke

100
Q

What is the distribution of outcomes after stroke

A

1/3 die, 1/3 severe disability and 1/3 mild disability

101
Q

Majority of strokes occur over age

A

74

102
Q

What are the risk factors for stroke

A

A fib, diabetes, genetics, high cholesterol, age, race

103
Q

When do symptoms usually appear in Parkinson’s

A

5-6 years before diagnosis

104
Q

What are the early motor symptoms of Parkinson’s

A

Bradykinesia, tremor, rigidity, asymmetrical distribution and postural instability

105
Q

What is hypokinesia

A

Slow movements associated with PD

106
Q

What is hypophonia

A

Loss of loud speech ( Parkinson’s )

107
Q

2 nutritional deficits that can cause peripheral NS issues

A

Folic acid and vitamin B12

108
Q

Folic acid is important for

A

When tissues and cells are growing rapidly

109
Q

Vitamin B 12 deficit can cause and what other function is it important for

A

Pernicious anemia due to malabsorption and brain cell function

110
Q

Heavy metals can cause

A

Toxic neuropathy

111
Q

What is chemotherapy induced peripheral neuropathy

A

Adverse effects damages nerves: pain, parasthesia and dyesthesia

112
Q

What causes Herpes Zoster shingles

A

A decline in cell mediated immunity

113
Q

What does Herpes Zoster shingles look like

A

Painful, blistering skin rash

114
Q

How long before herpes zoster shingles crusts over and isn’t contagious anymore

A

2 weeks

115
Q

What is postherpetic neuralgia associated with herpes zoster

A

Pain and allodynia

116
Q

What is seborrheic keratosis

A

A benign epidermal neoplasm

117
Q

What sections of the body does seborrheic keratosis effect

A

Head, neck and trunk

118
Q

What does seborrheic keratosis look like

A

Verrocous surface “stuck on” appearance, tan to brown in color

119
Q

What is the leading cause of blindness in those over 55

A

Macular degeneration

120
Q

What is the most common kind of macular degeneration

A

Dry - causes loss of blood vessels to the eye

121
Q

What is macular degeneration

A

Breakdown of layer of retinal pigment epithelial cells in macula

122
Q

Symptoms of macular degeneration

A

Color perception, loss or blurry central vision

123
Q

What is cataracts

A

Lumping of proteins that clouds the lens

124
Q

What is the prevalence of cataracts

A

70% in those over 75

125
Q

What are the symptoms of cataracts

A

Blurry vision, night vision, faded colors, double vision

126
Q

What is glaucoma

A

Increased intraocular pressure / blocked outflow in drainage canal

127
Q

What is the most common type of glaucoma (90%)

A

Open angle that damages the optic nerve

128
Q

What is presbycusis

A

Inability to hear high frequency sounds

129
Q

What is tinnitus

A

Constant crackling, buzzing, ringing or whistling

Distortion of accurate reception of voices/environment

130
Q

What is otalgia

A

Ear pain from an otologic process that may refer along the neural pathway

131
Q

The neural pathway effected by otalgia

A

Trigeminal, glossopharyngeal, vagus and cervical nerves

132
Q

What may cause ear pain from another structure by referred pain

A

TMJ pain

133
Q

Accumulation of cerum results in feelings of

A

Fullness or dizziness

134
Q

A possible reason for accumulation of cerum

A

Dehydration

135
Q

Dysphagia can be a symptom of what what issues

A

Neuro condition , tumor or mechanical issue

136
Q

A lower UTI is called

A

Urethritis

137
Q

An upper UTI is called

A

Bladder infection or cystitis

138
Q

Risk factors for UTI

A

Female, cathederization, weak pelvic floor, diabetes, MS, SCI, urinary obstruction, kidney stones, large prostate, AD, PD, history of neurogenic bladder and history of stroke

139
Q

What is acute renal failure

A

The kidneys are unable to filter properly causing a rapid buildup of toxic waste products and drugs, fluid overload, and elevation of serum potassium

140
Q

What is chronic renal failure

A

Slow deterioration of renal function causing a permanent loss of nephrons

141
Q

What is the leading cause of renal failure

A

DM and HTN

142
Q

What are the signs and symptoms of renal failure

A

Anemia, fatigue, wasting, reduced work capacity, low exercise capacity.

143
Q

Stage one renal failure

A

Diminished renal reserve, glomerular filtration rate about 50% of normal

144
Q

2nd stage renal failure

A

Renal insufficiency, GFR about 20-35% of Normal

145
Q

What two key characteristics appear in 2nd stage renal failure

A

Anemia and HTN

146
Q

3rd stage renal failure

A

Renal failure , GFR <20% of normal, kidneys unable to regulate volume and solute composition

147
Q

4th stage renal failure

A

Aka end stage renal disease, 90% of kidney function has been lost

148
Q

What is diabetes mellitus

A

Progressive disease caused by a combination of metabolic disorders that result from coexisting defects of multiple organ sites

149
Q

In DM ___ cells lose the inability to _________

A

Beta cells , produce insulin

150
Q

Many people have DM ___ years before diagnosis

A

10

151
Q

Most common type (cell) of cancer

A

Carcinomas

152
Q

Carcinoma cells ______

A

Cover external and internal body surfaces

153
Q

Sarcoma cells _____

A

Found in supporting tissues

154
Q

Lymphomas are found in

A

Lymph nodes and tissues of the immune system

155
Q

Leukemias are

A

Immature blood cells that grow in bone marrow

156
Q

Cancer affect ___ in ___ women and __ in ____ men

A

1 in 3 and 1 in 2

157
Q

What is the most common kind of cancer

A

Skin

158
Q

About ___% over 65 have skin cancer

A

50

159
Q

What is the ABCDE method for evaluating a mole

A

Asymmetry, border irregular, ragged or notched edges, Color, diameter greater than 6 mm, evolution, enlargement or elevation

160
Q

Hypothermia is core temp of ___ or lower

A

95 F

161
Q

Signs of hypothermia

A

Slow or slurred speech, sleepiness or confusion, shivering or loss of mobility in extremities, poor control of movements, slow reactions, weak pulse

162
Q

What is heat stroke

A

A life threatening form of hyperthermia where body temp is greater than 104 F

163
Q

Symptoms of hyperthermia

A

Mental status changes, strong rapid pulse, lack of sweat, dry flushed skin, faintness, staggering, coma

164
Q

What is panic disorder

A

A sudden unexplained attack of terror or fear

165
Q

Symptoms of panic disorder

A

Heart palpitations, sweating, chill, weak, faint, dizzy, extremity tingling, numb, nausea, chest pain or dyspnea

166
Q

Four common causes of chronic disease

A

Inactivity, poor nutrition, tobacco use, excessive alcohol consumption

167
Q

How many adults do not meet physical activity recommendations

A

1/3

168
Q

Only ___% of adults reported eating 5 or more servings of fruits and veggies per day

A

24%

Gerontology (12 decks)

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