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Geriatrics > Potpourri > Flashcards

Potpourri Flashcards

1
Q

Define Hypertension

A

BP >140/90

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2
Q

Define Isolated Systolic Hypertension

A

Systolic BP >140 & diastolic BP less than 90

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3
Q

Associated Conditions with HTN

A 
MI
CVA
PVD
CHF
Renal failure
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4
Q

CV Disease Risks

A

Continuous & consistent HTN & independent of other risks
Each 20/10 mmHg rise doubles risk of CVD

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5
Q

Benefits of Lowering BP

A

Decreased risk of stroke, MI, & HF

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6
Q

Define Dementia

A

Cognitive impairment more common with HTN

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7
Q

Accurately Measuring BP

A

Cuff size
Correct inflation
Appropriate interval
Several readings

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8
Q

Possible Reasons for Secondary HTN

A 
Sleep apnea
Drug-induced
Chronic kidney disease
Primary aldosteronism
Reno vascular disease
Chronic steroid therapy or Cushing's syndrome
Pheochromocytoma
Coarctation of the aorta
Thyroid or parathyroid disease
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9
Q

CVD Risk Factors

A 
HTN
Cigarette smoking
Dyslipidemia
Obesity
Physical inactivity
DM
Microalbuminuria or GFR less than 60 mL/min
Age: 55+ for men, 65+ fro women
Family Hx of premature CVD (men less than 55 or women less than 65)
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10
Q

Target Organ Damage

A 
Heart: LVH, angina, prior MI, prior coronary revascularization, CHF
CVA/TIA
Renal disease
PAD
Retinopathy
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11
Q

Aggressive BP Management

A

Weight loss
Sodium restriction
Treatment with all classes of drugs except hydrazine & minoxidil

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12
Q

Laboratory Tests for BP Issues

A 
EKG
UA
CMP
Fasting lipid panel
H/H
TSH
Microalbumin
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13
Q

Lifestyle Modification for HTN

A 
Weight reduction
Adopt DASH eating plan
Dietary sodium reduction
Physical activity
Moderation of alcohol consumption
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14
Q

Medication Classes for HTN with Heart Failure

A 
Thiazides
Beta-blocker
ACEI
ARB
Aldosterone antagonists
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15
Q

Medication Classes for HTN with Status Post MI

A

Beta-blockers
ACEI
Aldosterone antagonists

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16
Q

Medications for HTN with High CAD Risk

A

Thiazides
Beta-blockers
ACEI
CCBs

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17
Q

Medications for HTN with DM

A 
Thiazides
Beta-blockers
ACEI
ARB
CCB
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18
Q

Medications for HTN with Chronic Renal Disease

A

ACEI

ARB

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19
Q

Medications for HTN with Recurrent Stroke Prevention

A

Thiazides

ACEI

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20
Q

What medication class is good for gout, history of hyponatremia, & osteopenia/osteoporosis?

A

Thiazides

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21
Q

What medication class is good for RAD or 2nd/3rd degree heart block, atrial tachycardia, migraines, thyrotoxicosis, essential tremor, or in the perioperative period?

A

Beta-blockers

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22
Q

What medication class is useful in Raynaud’s Syndrome?

A

CCBs

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23
Q

What medication class is useful in BPH?

A

Alpha blockers

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24
Q

What medication classes have a risk of pregnancy?

A

ACEI

ARBs

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25
Q

What medication classes are good for hyperkalemia?

A

Aldosterone antagonists

K-sparing diuretics

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26
Q

Define Orthostatic Hypotension

A

Drop in standing SBP >10 mmHg

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27
Q

When should you always check orthostatic BP?

A

When adjusting meds

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28
Q

Differential Diagnosis of Marked BP Elevations & Acute Target Organ Damage

A 
Encephalopaty
TIA/CVA
Papilledema
MI or unstable angina
Pulmonary edema
Life-threatening arterial bleeding or aortic dissection
Renal failure
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29
Q

Define Hypertensive Emergency

A

Marked BP elevations & acute target organ damage

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30
Q

Define Hypertensive Urgency

A

Market BP elevation but NO acute target organ damage

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31
Q

Define Pseudohypertention

A

When BP readings may be falsely elevated in some elderly patients with very stiff, calcified arteries

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32
Q

Treatment of HTN Reduces Incidence of

A

MI
Stroke
HF

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33
Q

What should you evaluate for with HTN in the elderly?

A

Target organ damage

Other CV risk factors

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34
Q

What is the 3rd leading cause of death & disability in the developed world?

A

CVA

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35
Q

Complications of Strokes

A

Venous thromboembolism
MI during acute period
MI or CVA first?

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36
Q

Major Risk Factors

A 
HTN
Smoking
Atrial fibrillation
MI
Hyperlipidemia
DM
CHF
Acute ETOH abuse
TIA with >70% occlusion of carotid arteries
OCP + smoking
Hypercoagulopathy
High RBC count & hemoglobinopathy
Age, gender, race, prior stroke, & heredity
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37
Q

2 Types of Stroke

A

Ischemic

Hemorrhagic

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38
Q

Define TIA

A

Brief episodes of focal neurological deficits lasting 2-3 minutes to at most a few hours but less than 24 hours with no residual deficits with complete functional recovery

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39
Q

TIA Warning Sign of What

A

Impending stroke

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40
Q

Define Completed Stroke

A

Acute, sustained functional neurological deficit lasting from days to permanent

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41
Q

Stroke Syndromes

A 
Internal carotid artery (ICA) occlusion
ACA occlusion
MCA occlusion
PCA occlusion
Vertebrobasilar occlusion
Lacunar infarct
Spinal stroke
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42
Q

Anterior Circulation TIA’s & Stroke

A

Anterior or middle cerebral artery
Amaurosis fugax (monocular blindness)
Face-hand-arm-leg contralateral hemiparesis
Aphasia/dysarthria

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43
Q

MCA Occlusion

A

Contralateral hemiplegia in face-arm-hand
Dominant hemisphere = aphasia
Non-dominant right hemisphere = confusion, spatial disorientation, sensory & emotional neglect

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44
Q

ACA Occlusion

A

Sensorimotor deficit in contralateral foot & leg
Brocas or anterior conduction aphasia in dominant hemisphere
TIA’s rarely affect ACA distribution

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45
Q

Posterior Circulation TIA & Stroke

A 
Vertigo
Diplopia/dysconjugate gaze, ocular palsy homonymous hemianopsia
Sensorimotor deficits
Dyarthria
Ataxia
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46
Q

Vertebro-Basilar Posterior Circulation Occlusion

A 
VA-PICA syndrome
Horner's syndrome
PICA-AICA-SCA acute cerebellar infarction
BA
V-B junction
Basilar apex
PCA quadrantic or homonymmous hemianopsia
PCA thalamus involvement
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47
Q

VA-PICA Syndrome

A

Headache
Ataxia
N/V
Ipsilateral paralysis in tongue & swallowing
Ipsilateral face & contralateral body

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48
Q

V-B Junction

A 
Lower extremity paraplegia or tetraplegia
Conjugate or dysconjugate gaze paralysis
Constricted pupils
Respiratory depression
Coma
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49
Q

Basilar Apex

A 
PCA junction results in hemiplegia-diplegia
Pupillary & occulomotor paralysis
Visual field defects
Stupor
Coma
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50
Q

PCA (proximal branches) Thalamus Involvement

A

Memory loss

Sensorimotor hemiplegias

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51
Q

Spinal Stroke

A

Prolonged hypotension

Intraspinal mass lesions

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52
Q

Define Lacunar Infarct

A

Small, deep infarcts caused by occlusion of the small arteries that penetrate deeper brain structures

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53
Q

Types of Hemorrhagic Stroke

A

Subarachnoid hemorrhage

Intracerebral hemorrhage

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54
Q

Presentation of Hemorrhagic Stroke

A

Headache
N/V
Decreased consciousness

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55
Q

Types of Intracerebral Hemorrhage

A 
Hypertensive atherosclerotic hemorrhage
Lobar hemorrhages
Hemorrhage from vascular malformations
Bleeding into brain tumors (uncommon)
Blood dyscrasias or anticoagulants (uncommon)
Inflammatory vasculopathies (uncommon)
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56
Q

Define Subarachnoid Hemorrhage

A

Rupture of an artery with bleeding onto the surface of the brain

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57
Q

Causes of Subarachnoid Hemorrhage

A

Aneurysm
AVM
Bleeding disorder due to anticoagulants

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58
Q

Describe Subarachnoid Hemorrhage

A 
Worst headache ever
Radiates to face & neck
Phonophobia
Photophobia
Maximal intensity immediately after onset
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59
Q

Subarachnoid Hemorrhage Physical Signs

A 
Nuchal rigidity
Altered mental status
Poor sign if with transient loss of consciousness (seizure, cardiac dysrhythmia)
Papilledema
May not have neurological defect
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60
Q

Define Intracerebral Hemorrhage

A

Rupture of an artery with bleeding into the brain parenchyma

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61
Q

1 Cause of Intracerebral Hemorrhage

A

Hypertension

Amyloid angiopathy

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62
Q

Differential Diagnosis of Stroke

A 
Focal seizures
Glaucoma
Benign vertigo or Menieres disease
Cardiac syncope or syncope from other causes
Migraine HA
Intracranial neoplasm
Subdural hematoma
Epidural hematoma
Hyperglycemia
Hypoglycemia
Postcardiac arrest ischemia
Drug overdose
Meningitis, encephalitis
Trauma
Anoxic encephalopathy
Hypertensive encephalopathy
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63
Q

Diagnosis of Stroke

A 
ABCs
H&P
EKG, monitor, pulse oximetry
Labs: CBC, electrolyte, glucose, ABG, PT/PTT, Urine drug screen, LP
CT or MR head scan
Echo, EEG
Carotid duplex ultrasonogrpahy
MRA or angiography
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64
Q

Management of Acute Stroke

A

Medical management
Surgical management
Prognosis

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65
Q

Medical Management

A

Prevention, lifestyle modification
Early recognition with rapid transport/pre-arrival notification
ABCs, O2, IV
Rapid evaluation for TPA

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66
Q

Thrombolytics

A

Only for ischemic stroke if given within 3 hours of onset of signs and symptoms Class I AHA recommendation

67
Q

Contraindications Thrombolytics

A 
BP >185/110
AMI
Seizure
Hemorrhage
LP within 7 days
Atrial puncture at incompressible site
Surgery within 14 days
Bleeding diathesis
Within 3 months of head trauma
Hx of intracranial hemorrhage
Minor or rapidly improving stroke symptoms
68
Q

Chronic Prophylactic Anticoagulation Indications

A

Acute anterior MI with mural thrombus formation
Chronic a-fib with CHF within 3 months, HTN, previous thromboembolism, LV dysfunction and/or enlarged left atrium, or chronic valvular disease
A-fib without any risk factors: ASA therapy

69
Q

Chronic Management of Stroke

A 
Multidisciplinary approach
Psychiatric services
PT/OT/speech-language
VNS/home health attendant
Skilled nursing facility
Social services
Family support groups
70
Q

Perform Carotid Endarterectomy

A

Good general health
HTN controlled
Internal carotid stenosis 70-99%
Ipsilateral stroke or TIA within 3-6 months
Surgeon with morbidity/mortality less than 2%
Worse outcome if used to treat stroke

71
Q

Maybe Carotid Endarterectomy

A 
Multiple coexisting comorbid conditions
HTN poorly controlled
Internal carotid artery either completely or less less than 70% occluded
No history of ipsilateral TIA or stroke
Inexperienced surgeon
72
Q

Define Parkinson’s Disease

A

Idiopathic slowly progressive degenerative CNS disorder characterized by tremor, muscular rigidity, bradykinesia

73
Q

Physiology of Parkinson’s Disease

A

Striatal dopamine is deficient & dopaminergic neurons are lost in the substansia nigra

74
Q

Diagnosis of Parkinson’s Disease

A

H&P

Clinically if 2/3 cardinal features

75
Q

Cardinal Features

A

Tremor
Rigidity
Bradykinesia

76
Q

Symptoms of Parkinson’s Disease

A 
Stiffness & slowed movements
Tremor or shaking at rest
Difficulty getting out of chair or rolling in bed
Frequent falls or tripping
Difficulty walking
Memory loss
Speech changes
Small handwriting
Slowness in performing ADLs
Sialorrhea
77
Q

Physical Findings in Parkinson’s Disease

A 
Muscle rigidity, cog wheeling type
Bradykinesia
Postural instability, stooped forward posture
Decreased arm swinging in ambulatory activity
Resting/tremor/pill-rolling tremor
Masked facies
Micrographia
Dysarthria, hypokinetic, monotonous low volume
Painful dystonia
Dementia
Depression
Akathisia inability to sit still
Seborrheic dermatitis face & scalp
Autonomic dysfunction
78
Q

Differential Diagnosis of Parkinson’s Disease

A 
Progressive supranuclear palsy
Multisystem atrophy
Shy-drager syndrome
Olivopontocerebellar atrophy
Wilson disease
Multiple strokes
Subdural hematoma
Normal pressure hydrocephalus
Basal ganglion lesion
Hypothyroidism & hyperparathyroidism
Post encephalitis
Creutzfeldt-Jacob disease
79
Q

Treatment of Parkinson’s Disease

A 
Carbidopa/levodopa
Dopamine
MAOIs type B
Catechol-O-methyltransferase inhibitors
Amantadine
DBS
Regular exercise
80
Q

End of Life Issues for Parkinson’s Disease

A 
Severely impaire & immobile
At risk for aspiration
Eating may become impossible
Dementia
Discuss end-of-life care issues early
Advise patient to appoint a surrogate to make medical care decisions
81
Q

Define Polymyalgia Rheumatica

A

Inflammatory condition which is characterized by severe bilateral pain & morning stiffness of the shoulder, neck, & pelvic girdle

82
Q

Epidemiology of Polymyalgia Rheumatica

A

Increased incidence at higher latitudes

Women > Men (3:1)

83
Q

Presentation of Polymyalgia Rheumatica

A

Bilateral, severe, persistent pain in the neck, shoulders, & pelvic girdle
Pain on active & passive movement of joints
Morning stiffness more than 1 hour & after periods of rest
Myositis
Lethargy
Weight loss
Depression
Fever
Joint effusions
+/- asymmetric peripheral arthritis, carpal tunnel syndrome, edema of hands, wrists, ankles, & feet

84
Q

Important Differential Diagnosis of Polymyalgia Rheumatica

A 
Systemic lupus erythematosus
Polymyositis
Bacterial endocarditis
Paraneoplastic syndromes
Amyloidosis
85
Q

Labs for Polymyalgia Rheumatica

A 
ESR: elevated
CRP
IL-6 levels: elevated
CBC: anemia of chronic disease
Rheumatoid & ANA: not elevated
LFTs mildly elevated
86
Q

Associated Diseases with Polymyalgia Rheumatica

A

Giant cell arteritis (GCA)

87
Q

Management of Polymyalgia Rheumatica

A

Document symptoms & level of disability at diagnosis
Consider giant cell arteritis
Advise to seek treatment if symptoms of GCA
Monitor response to treatment via ESR & CRP
Manage residual physical or psychosocial disability
Consider other possible diagnoses
Drug therapy: prednisone, bisphosphonates, calcium & vitamin D
Referral to physiotherapist & OT

88
Q

Symptoms of GCA

A

Headache
Jaw claudications
Visual disturbances

89
Q

Prednisone & Polymyalgia Rheumatica

A

Some may produce dramatic response
Some may be able to come off treatment all together except exacerbations
Some may need to be on long term low dose steroids

90
Q

Age-Related Macular Degeneration Impacts

A

Ability to drive
Increased rates of falls
Ability to live independently

91
Q

Define Age-Related Macular Degeneration

A

Degenerative disease of the central portion of the retina (macula)
Results in loss of central vision

92
Q

2 Classifications of Age-Related Macular Degeneration

A

Dry

Wet

93
Q

Dry Age-Related Macular Degeneration

A

Ischemic
Retinal epithelial cell apoptosis
Activating inflammation

94
Q

Wet Age-Related Macular Degeneration

A

Balance between substances that promote or inhibit blood vessel development
Vascular endothelial growth factor (VEGF)

95
Q

Risk Factors for Age-Related Macular Degeneration

A 
Age
Smoking
Genetics
CVD
Diet
Cataract surgery
Heavy alcohol use
Caucasians
96
Q

History of Age-Related Macular Degeneration

A 
Rate of vision loss
One or both eyes involved
Loss near/far vision or both
Associated symptoms
Acute distortion of loss of central vision: may be wet
97
Q

Ophthalmologic Evaluation of Dry Age-Related Macular Degeneration

A

Durban appears as bright yellow spots
Atrophy appears as areas of depigmentation
May be increased pigmentation

98
Q

Ophthalmologic Evaluation of Wet Age-Related Macular Degeneration

A

Subretinal fluid and/or hemorrhage
Neovascularization: grayish-green discoloration
Often require fluorescein angiogram

99
Q

Treatment of Dry Age-Related Macular Degeneration

A

None

Slow progression: vitamin C, E, beta carotene, zine & copper

100
Q

Treatment of Wet Age-Related Macular Degeneration

A

VEGF inhibitors
Photocoagulation
Surgery

101
Q

Tool for Detecting Age-Related Macular Degeneration

A

Amsler grid

102
Q

Types of Glaucoma

A

Acute angle
Secondary
Congenital
Primary open-angle

103
Q

Secondary Glaucoma Due to

A

Uveitis
Old trauma
Steroid therapy

104
Q

What glaucoma is the most common?

A

Primary open-angle glaucoma

105
Q

What is the leading cause of irreversible blindness in the world?

A

Glaucoma

106
Q

Primary Open-Angle Glaucoma

A

Optic neuropathy: “cupping”
Peripheral visual field loss followed by central field loss
Must be screened for

107
Q

Risk Factors for Primary Open-Angle Glaucoma

A

Elevated IOP
Increasing age with increase risk of blindness
African Americans 4-5 x risk
Family history

108
Q

Screening for Primary Open-Angle Glaucoma

A

Specialist with special equipment

Can examine optic disc for cupping

109
Q

Treatment of Primary Open-Angle Glaucoma

A

Topical & systemic medications
Laser therapy
Surgery

110
Q

Types of Angle-Closure Glaucoma

A

Primary

Secondary

111
Q

Primary Angle-Closure Glaucoma

A

Anatomically predisposed

No identifiable secondary cause

112
Q

Secondary Angle-Closure Glaucoma

A

Responsible for closure of the anterior chamber angle

Ex: fibrovascular membrane, mass, or hemorrhage

113
Q

Risk Factors for Angle-Closure Glaucoma

A 
Family history
Older than 40-50
Female
Hyperopia (farsightedness)
Pseudoexfoliation
Race: Inuit & Asian populations
114
Q

Symptoms of Pressure Rising Acutely in Angle-Closure Glaucoma

A 
Decreased vision
Halos around lights
Headache
Severe eye pain
N/V
115
Q

Signs of Angle-Closure Glaucoma

A

Conjunctival redness
Corneal edema or cloudiness
Shallow anterior chamber
Mid-dilated pupil that reacts poorly to light

116
Q

Treatment of Angle-Closure Glaucoma

A

Ophthalmologic emergency

Immediate referral for further evaluation

117
Q

What is the leading cause of blindness in the world?

A

Cataract

118
Q

Risk Factors for Cataracts

A 
Age
Smoking
Alcohol
Sunlight exposure
Metabolic syndrome
DM
Systemic corticosteroid use
119
Q

Presentation of Cataracts

A

Painless, progressive process
Complain of problems with night driving, reading road signs or difficulty with fine print
Increase in nearsightedness

120
Q

Physical Exam Findings in Cataracts

A

Lens opacity

Darkening of the red reflex, opacities, or obscuration of ocular funds detail

121
Q

Treatment of Cataracts

A

Surgery

122
Q

Pre-Op for Cataract Surgery

A

Controlled HTN

Maintain medication use

123
Q

Complications of Cataract Surgery

A

Endophthalmitis

Retinal detachment

124
Q

Common Etiologies of Presbycusis

A

Sensorineural
Bilateral
Beginning in the high frequency range

125
Q

Risk Factors for Presbycusis

A 
Lifetime exposure to noise
Genetics
Medications
Older age
DM
Cerebrovascular disease
Smoking
HTN 
White
126
Q

Presentation of Presbycusis

A

Complain of inability to hear/understand speech in crowded or noisy environment
Difficulty understanding consonants
Inability to hear high pitched voiced

127
Q

Associated Symptoms of Presbycusis

A

Tinnitus

Hearing pulsatile noise in one ear (need MRA or MRI)

128
Q

Differential Diagnosis of Presbycusis

A

Cerumen impaction
TIA
CVA

129
Q

What can presbycusis lead to?

A

Isolation
Depression
Low self-esteeem

130
Q

Hearing Amplification

A

Done through licensed audiologist
Do not restore hearing to normal
Need to be fit and programmed properly

131
Q

Signs/Symptoms of Hypothyroidism

A 
Fatigue
Cold intolerance
Weakness
Lethargy
Weight gain
Constipation
Myalgias, arthralgias
Menstrual irregularities
Hair loss
Dry, course skin
Hoarse voice
Brittle nails
Myxedema
Delayed reflexes
Slow reaction time
Bradycardia
132
Q

Define Subclinical Hypothyroidism

A

Normal T4

Elevated TSH

133
Q

Define COPD

A

Slow progressive irreversible airway obstruction

134
Q

Signs of COPD Exacerbations

A

Increased dyspnea
Infections
Respiratory failure

135
Q

Risk Factors for COPD

A 
Smoking
Exposure to inhalants
Alph-1 antitrypsin
Asthma
Age
Genetics
136
Q

Pathophysiology of COPD

A

Inflammation
Increased mucus
Decreased ciliary movement
Air flow obstruction

137
Q

Pathophysiology of Chronic Bronchitis

A

Hypertrophy of the mucus cells
Increase in number of mucus cells
Inflammation leads to formation of more mucus

138
Q

Why Acute Exacerbations in COPD

A

Infections
Environmental pollution
Unknown

139
Q

Treatment of COPD

A 
Oxygen
Long term inhaled glucocorticoids
SABAs (add on)
Short acting anticholinergics (add on)
Glucocorticosteroids (add on)
140
Q

Complications of COPD

A 
Cor pulmonale
Pneumonia
Pneumothorax
Polycythemia
Arrhythmias
141
Q

Local Deposition Effects of Inhaled Glucocorticoids

A

Dyphonia
Thrush
Cough/throat irritation/reflex bronchoconstriction

142
Q

Systemic SE of Inhaled Glucocorticoids

A

Consider pharmacokinetics
Osteoporosis
Adrenal suppression
Increase intra-ocular pressure/cataracts

143
Q

Signs of Worsening COPD

A

Decrease in BMI
Decrease in FEV1
Increased dyspnea on exertion
Need for O2

144
Q

End Stage COPD

A 
Hospice
Control pain
Bedridden
Support family
Get living will from patient
145
Q

Predisposing Conditions for Community Acquired Pneumonia

A 
Smoking
Alcohol consumption
Pulmonary edema
Malnutrition
Administration of immunosuppressive agents
Being 65+
COPD
Previous episode of pneumonia
146
Q

Pathogens of Community Acquired Pneumonia

A

H. flue
Chlamydia
Strep pneumo

147
Q

Risk Factors for Drug Resistance

A 
65+ years old
Antibiotic therapy within last 3-6 months
Alcoholism
Medical comorbidities
Immunosuppressive illness or therapy
148
Q

Treatment of Uncomplicated Community Acquired Pneumonia

A

Azithromycin
Erythromycin
Clarithromycin

149
Q

Treatment of Complicated Community Acquired Pneumonia (cormobidities or recent antibiotic use)

A

Respiratory fluoroquinolones

Amoxacillin-clavulanate (Augmentin)

150
Q

Indications for Hospitalization of Community Acquired Pneumonia

A 
CRB-65
Confusion
Respiratory rate: >30
BP: less than 90 systolic or 60 diastolic
Age: >65
151
Q

Underlying Factors of Patients in Long Term Care Facilities with Pneumonia

A

COPD
Left heart failure
Aspiration

152
Q

Parameters for Long Term Care Facility Residents for Treatment

A 
Able to eat & drink
Pulse: less than 100
Respiratory rate: less than 30
BP: >90 or decrease of less than 20 from baseline
O2 sat: >92% or 90% if COPD
153
Q

Common Causes of Pain in the Elderly

A 
Osteoarthritis
Other joint diseases
Night time leg cramps
Claudication
Neuropathies: diabetics, herpetic, idiopathic
Cancer
154
Q

Why is pain underrated in the elderly?

A

Patients underreport

Health care providers hesitant to prescribe opiates

155
Q

WHO Guidelines for Pain Management

A

Mild: non-opioid +/- adjuvant
Moderate: opioid +/- adjuvant
Severe: stronger opioid +/- adjuvant

156
Q

Medications NOT to Use for Pain Management in the Elderly

A

Amitriptyline

Propoxyphene

157
Q

SE of NSAIDs in the Elderly

A

Renal toxicity
GI
Cardiotoxicity: worsen CHF & HTN
Interacts with aspirin & warfarin

158
Q

First Line Treatment of Pain in the Elderly

A

Tylenol

Arthritis strength Tylenol

159
Q

Treatment of Neuropathic Pain in the Elderly

A

Gabapentin
Lyrica
Cymbalta

160
Q

Opioids & the Elderly

A

Small doses spread apart

Talk heavily about SE including constipation & confusion

161
Q

Adjuvant Therapies for Pain Management

A 
Exercise: PT, OT, strengthening
Physical methods: ice, heat, massage
CBT
Chiropractic therapy
Acupuncture
Relaxation & guided imagery
Biofeedback
162
Q

Define Osteoporosis

A

Disease characterized by low bone mass with micro architectural disruption & skeletal fragility

163
Q

Risk Factors for Fractures

A 
Advanced age
Previous fracture
Long-term glucocorticoid therapy
Low body weight (less than 127 pounds)
Family history of hip fracture
Smoking
Excess alcohol intake
164
Q

Treatment for Fractures

A 
Surgery
Analgesics
Calcitonin
Vertebroplasty
Kyphoplasty

Geriatrics (15 decks)

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