Pathological disease in the elderly Flashcards
Considering fractures, what type of bone is more often involved?
trabecular bone (vs. cortical bone)
Where do most fractures occur in the elderly?
spine
femoral neck
distal radius/wrist
humerus
Your patient comes into your clinic complaining that his back hurts and has ever since getting up and out of his chair. He says it hurts more when he bends over, and it’s focal, sharp pain. What could be going on that you need to consider?
vertebral compression fracture
What three MS injuries/issues are more common in the elderly?
1) osteoporosis/penia
2) fractures
3) degernative arthritis (OA)
4) cachexia
What does delirium look like?
acute onset, often at night
- orientation issues, hallucinations, memory issues (immediate and recent), disorganized thinking
What could cause a patient to become delirious?
- deprived of O2 to the brain
- drug toxicity
- environmental changes and sensory deprivation (ex. recent hospitalization)
What type of dementia is sudden onset?
vascular dementia = large/small vascular infarcts in gray and white matter of brain, resulting in loss of brain fxn
A score of what on the mini mental exam can indicate dementia?
<24/30
T/F: Angina is a consistent indicator of ischemia in the elderly.
false -> shortness of breath and/or ECG ST segment depression may be more reliable
How might an elderly adult’s MI presentation differ from a younger person’s MI?
elderly adult can have syncope, sudden dyspnea, confusion
How might an older adult’s pneumonia presentation look like compared to a younger person’s?
older adult = tachy, dehydration, altered mental status
younger adult = high fever and productive cough
What does medicare part A cover?
hospital insurance
- inpatient hospital care, SNF, hospice, home health
What does medicare part B cover?
medical insurance
- physician services, outpatient services, DME
T/F: Immobility can result in decreased glucose tolerance.
true
T/F: Aging results in decreased proprioceptive function.
true
Why is an older adult more at risk for falls d/t aging?
- decreased response/reaction times
- weaker muscles with decreased ROM
- psychotropic drugs they may be on for depression, or decreased BP drugs causing low BP/syncope
- sensory changes like decreased vision/sensation, increased need for support surface input for balance
T/F: The more medicines a person is on, the higher their risk of falls.
true
T/F: Fall risk is much higher for those institutionalized than for those community-dwelling elderly.
true
When a patient informs you they’ve had a fall, what follow up questions should you ask?
location, activity, time, symptoms, previous falls
- then examine all systems: skin, CV, cognitive, sensory
- FOLLOW UP WITH STANDARDIZED BALANCE EXAM
How might you modify the environment to reduce falls?
- adequate lighting
- no trip hazards like clutter or rugs
- contrasting colors to delineate hazardous areas like stairs
When your patient falls in your clinic, what should you do?
DO NOT ATTEMPT TO PICK UP PATIENT
- assess for consciousness
- palpate hip, look for sensation/voluntary movement of legs
- assess for cuts, bruising, bleeding
- reassure pt and get help
T/F: Older adults have a higher risk for drug toxicity.
true b/c they process drugs slower
- also have altered reactions to drugs: more sensitive, less sensitive
What kinds of drugs can increase falls?
psychotropic, blood pressure meds, neuroleptics, antipsychotics
What would be some side effects of medications you would want to look out for in the elderly?
weakness postural hypotension sedation confusion/dementia incontinence drug-induced movement disorders depression
