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Geriatrics > Presentationof Disese In The Elderly > Flashcards

Presentationof Disese In The Elderly Flashcards

1
Q

What are some barriers to eliciting a helpful hx?

A

Language/culture
Education/life experience
Fear of loss of autonomy
Fear of pain/cost
Hearing and vision difficulties
Depression/apathy
Misunderstanding the significance of symptoms
Mental status abnormalities
Symptoms related to organ system from one other than the pathology: delirium due to hypoxia from COPD
Multiple disease states
Attitudes of care givers: not looking for reversible causes of sx like meds

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2
Q

Bi basilar lung cracked are common in what?

A

Normal elderly lung and pneumonia

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3
Q

How might an infection present differently in the elderly?

A

No fever, which carries a worse prognosis than having a fever

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4
Q

What isn’t cause of majority of influenza fatalities?

A

Pneumonia

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5
Q

What influenza drug therapy is preferred in an older patient?

A

Oseltamivir

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6
Q

What constitutes a nursing home influenza outbreak and what is the management?

A

3 or more PTS. W/ fever of 101 and flu like symptoms w/in 3 days

  1. Isolate symptomatic patients
  2. Encourage staff to stay home if I’ll
  3. Vaccinate any susceptible patients
  4. Consider anti-viral prophylaxis
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7
Q

Cancer signs and symptoms?

A
  1. New weight loss
  2. Increasing fatigue
  3. Recent change in taste
  4. Decreased appetite
  5. Acute mental status change
  6. HA
  7. Spine pain
  8. Low impact frx
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8
Q

New onset serous otitis media can indicate what?

A

Oral cancer

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9
Q

What is the second MC cause of death worldwide?

A

Stroke

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10
Q

What tests should you have for your eyes?

A

> 60 annual tonometry

Diabetic: annual optometrist/ophthalmologist exam

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11
Q

How to screen for macular degeneration?

A

Amsler grid

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12
Q

What medicating may cause hyperthyroidism?

A

Amiodarone: contains iodine

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13
Q

How does thyroid disease differ in elderly from younger patients?

A

Classic eye findings less common

Tremor may be benign

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14
Q

How might and MI present in the elderly?

A

No chest pain,

SOB, pulm edema, CHF, cardiac rupture, shock

Also new Heart block

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15
Q

What to do if someone presents w/ risk factors for CAD and atypical symptoms?

A

Perform ECG
Cardiac enzymes
Risk factors same as younger people

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16
Q

Treatment for acute coronary artery disease?

A

Throomboebolytic
CT
Daily aspirin, ACEI, b-blocker, statin

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17
Q

CHF is most commonly associated w/?

A

Systolic HTN

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18
Q

What test is the preferred test for evaluation of LV function, but what is the gold standard?

A

Echo preferred test, cardiac cath gold standard

19
Q

Treatment for systolic CHF?

A

ACEI for afterload reduction
Diuretic for volume
Digoxin for exacerbation
Beta blockers unless CI

20
Q

what is the MC valvular disease of the elderly and what’s it’s treatment?

A

MR and ACEI if mod-severe

21
Q

mitral stenosis is associate w/ __ ___ and its presentation looks like CHF or new onset fibrillation. treatment

A

rheumatic fever, thombolytic therapy

22
Q

aortic regurg treatment?

A

contraol HTN and treat dyslipidemia

23
Q

what is the second most common indication for heart surgery in the elderly after CABG?

A

aortic stenosis

24
Q

patient presents w/ exertional angina, dizziness, dyspnea? dx

A

aortic stenosis

25
Q

pt. presents w/ new onset afib/flutter. TRX workup?

A

rate/rhythm control, thrombolytic therapy

echo, r/o hyperthyroidism and electrolyte imbalance

26
Q

patient presents w/ ache in calf, buttock, or thigh that resolves w/ rest. They have dimished distal pulses and skin is cool to touch. They have non healing LE ulcers or gangrene. dx. trx

A

peripheral artery disease

reduce risks
exercise
Daily ASA
percutaneous angioplasty 
surgery
27
Q

pt. presens w/ edema aound the ankle that spares the dorsum of the foot. They have an ache, heaviness or tightness in the LE. They have varicose veins, painless ulcers and skin is war, dry, shiny and has bluish redish hue. DX trx

A

chronic venous insufficiency

compression stockings
frequent ulcer care
weight loss
exercise

28
Q

COPD therapy

A

o2 when hypoxic on room air

29
Q

when to screen for vit-b12 defieciency?

A

frail, changes in RBCs and WBCs w/ or w/o anemia (megolobastic?), gait disorder, unexplained neuro symptoms

30
Q

what can acute appenidicitis look like for elderly?

A

low grade fever and general abdominal pain, MUST SURGERIZE

31
Q

diverticulitis and or mesenteric/colonic ischemia can cause?

A

peritonitis, typ absent bowel sounds, generalized tenderness and rigidity. Hypotension and cv collapse will occur if untreated

32
Q

what might not occur in peptic ulcer disease?

A

evidence of perf like sudden pain and rigidity

33
Q

management of consitpation?

A

hydration, excercise, stool softender: colace, lactulose or sorbitol titrate to achieve a BM everyday or every other day

34
Q

work up for BPH?

A

DRE, urinanalysis, renal function tests

35
Q

treatment for BPH?

A

alpha 1 blocker, 5 alpha reductase, surgery: transurethral incision of prostate, transurethral resection of prostate

36
Q

is urinary incontience normal?

A

no

37
Q

types of urinary incontinence?

A

total, stress (increased abdominal pressure), urge (>7x perday or 2 or more at night), overflow (BPH) retention issue

38
Q

transient cause of urinary incontinence?

A 
diappers
delirium
infection
atrophic vaginitis
pharm
psych
excess fluid output
restricted mobility
stool impaction
39
Q

osteoarthritis treatment?

A

acetaminophen 1,000 mg

40
Q

treatment for gout?

A

NSAID (not indomethacin) or prednisone are alternative therapies

41
Q

patient presents w/ HA, scalp tenderness, jaw claudication, and vision loss. his ESR is greater than 50. dx treatment

A

giant cell arteritits (confirm w/ biopsy of temp. artery)

corticosteroids

42
Q

treatment for basal cell/squamous cell cacner?

A

electrodesiccation and curettage, or excision

43
Q

patient presents / scaly, rough, adherent lesion of face, lips, ears, forearms, dorasl asepcts of hands. what are you concerned for? dx trx

A

SCC
Actinic keratosis

cryotherapy, imiquimod, fluorouracil

Geriatrics (9 decks)

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