Presentation of disease Flashcards
What 3 forms can presentation of disease take in the elderly?
Typical
Atypical
Silent
In an atypical presentation of disease in elderly name 3 features that can mask typical symptoms?
Confusion
Reduced balance
Mood disturbances
What is a silent presentation? Why does it happen?
late presentation often acute
Due to limited ability to communicate, deliberate under reporting, reduced awareness
Classic effects of ageing sees what sorts of changes?
sarcopenia Decreased strength memory loss impaired hearing and vision impaired ability to compensate
What happens to water distribution as we age?
Less intracellular volume and more extracellular volume
Signs of cell breakdown in elderly?
Haemosiderin deposits
Lipofuscin deposits
Amyloid
What changes occur in the brain as we age?
Cerebral atrophy
Mood changes - isolation
Changes to circadian rhythm - sleep issues
Amyloid plaques and neurofibrillary tangles
Ischaemic changes
5 things that happen to your sight/eyes as you age?
Presbyopia Cataracts ARMD Ectropion lower eyelid Glaucoma
What causes presbyopia?
Loss of elasticity to the lens
What causes cataracts?
Denaturing of protein in the lens
What causes glaucoma?
Degeneration and obstruction of the trabecular meshwork that drains aqueous humour causing a build up of intraocular pressure
What is the name for age related changes to hearing? what type of deafness and what happens?
Presbyacusis
Degeneration of the cochlea and giant stereocilia
Sensorineural loss
How do your lungs and respiration change as you age?
Fibrosis
Limited expansion as you develop kyphoscoliosis from osteoporosis
reduced gas exchange
Why is there reduced drug clearance in elderly?
Liver changes
Kidney function decreases CKD
Main changes to bowels as we age?
Constipation
Diverticular disease
Presbyoesophagus
Symptoms of BPH?
Hesitancy Dysuria Feeling of incomplete emptying Urgency Incontinence Dribbling Weak flow
What is pseudo-gout and how is it made worse in elderly?
Calcium pyro-phosphate crystals build up in the joints
Made worse by long periods of inactivity
What can Vit D deficiency cause in elderly besides typical osteomalacia?
general malaise
Why is there a reduction in immune function in the elderly?
Bone marrow fibrosis
What is an extreme form of bone marrow fibrosis that can occur? What is it considered?
Myelofibrosis
Bone marrow cancer that replaces bone marrow with scar tissue
