Physiology

Question 1

If a pt is “normal,” when are physiological effects noticed?

Answer 1

when some stressor disturbs their homeostasis

Question 2

If a pt is diseased, compromised function is noticed in the ____ state.

Answer 2

resting

Question 3

Skin

what changes are normal in aging?

Answer 3

thin skin + skin tears

sagging and wrinkles (laxity)

uneven pigment

itchy, dry, cracking

Question 4

Skin

less fat, blood vessels, blood flow to skin, lean muscle mass, and nerve cells all contribute to what change?

Answer 4

decreased temperature regulation

increased risk for hypothermia, burns, etc.

Question 5

Skin

Although skin issues are common, what should you always consider in the elderly?

Answer 5

a deeper problem

*watch and wait is not a good tactic*

Question 6

Skin

What is the MC derm complaint in elderly?

Answer 6

pruritis

Question 7

Skin

what underlying disease can make people itchy?

Answer 7

renal disease

Question 8

Skin

How should you treat skin tears in the elderly?

a) let it heal by itself
b) steri-strips
c) suture
d) bandage

Answer 8

steri-strips

Question 9

Skin

which type of skin cancer is most common in elderly?

Answer 9

basal cell carcinoma

Question 10

Skin

How should you care for the elderly’s nails?

Answer 10

keep them trimmed but use extreme caution, esp in DM

Question 11

CV

what are the 3 risk factors for elderly heart disease?

Answer 11

sedentary lifestyle

hyperlipidemia

smoking

Question 12

CV

what is the leading killer of men and women in US?

Answer 12

coronary heart disease

Question 13

CV

is coronary artery disease a natural process of aging?

Answer 13

NO!!!

40% of people over 90y didn’t have it on autopsy

Question 14

CV

What is a red flag of CAD (or other heart dz too probably)

Answer 14

new and progressive symptoms

Question 15

CV

which valve is most commonly affected in the elderly?

a) aortic
b) pulmonary
c) mitral
d) tricuspid

Answer 15

aortic (e.g. sclerosis, stenosis, or regurg/insufficiency)

Question 16

CV

what 2 things put you on high alert that the elderly pt will report to you?

Answer 16

change in activity level

new s/s

Question 17

Pulm

what disease is among the top 10 causes of death?

Answer 17

pneumonia

Question 18

Pulm

what rare way can pneumonia present?

Answer 18

with delerium and nothing else!

+/- abd symptoms, falls, health decline

Question 19

Pulm

should you admit an elderly pt who has pneumonia?

Answer 19

ADMIT CAUTIOUSLY.

Admissions lead to some degree of loss of function

Question 20

Pulm

what vital sign contributes to delerium?

Answer 20

low O2

Question 21

Pulm

how does lung cancer present?

Answer 21

in its late stages

could be local, intrathoracic, extrathoracic, paraneoplastic

Question 22

Pulm

local sx of lung cancer

Answer 22

cough

CP or weight on chest

dyspnea or can’t get full breath

hemoptysis

Question 23

Pulm

intrathoracic sx of lung cancer

Answer 23

chest wall pain

dysphagia

hoarseness

Question 24

Pulm

extrathoracic spread of lung cancer

Answer 24

abdominal pain

bone pain

jaundice

LAD

neuro sx

Question 25

Pulm

paraneoplastic spread of lung cancer

Answer 25

clubbing

cushing’s syndrome

high Ca

Question 26

Pulm

is COPD easy to detect in elderly?

Answer 26

not usually because there are usually a lot of other comorbidities

Question 27

What other very common elderly disease might present as delerium?

Answer 27

UTI

Question 28

MSK

is joint stiffness and pain a sign of arthritis in the elderly?

Answer 28

not always

also a normal process of aging

Question 29

MSK

what should all elders have in their treatment plan?

Answer 29

exercise

Question 30

MSK

what puts a patient at risk for falls?

Answer 30

you could figure this out on a multiple choice

osteoporosis, sarcopenia (muscle weakness), decreased vision, loss of balance/coordination, not using walker, nocturia, lalallaa

Question 31

Falls

When is someone at a higher risk for falls

Answer 31

acute illness

institutionalization

transition of care

home + community-based care recipients

if they have fallen in past year

etc.