Week 1 Flashcards

Question

Lab results: Blood chemistry Albumin

Answer 1

Normal: 3.5-5.0 Changes with age: Decline Comments: Related to decrease in liver size and enzymes; protein-energy malnutrition common

Answer 2

Normal: 2.3-3.5 Changes with age: Slight increase

Answer 3

Normal: 6.0-8.4g Changes with age: No change Comments: Decrease may indicate malnutrition, infection, liver disease

Answer 4

Normal: Men 10-25mg Women 8-20mg Changes with age: Increases significantly up to 69mg Comments: Increases significantly up to 69mg

Answer 5

Normal: 0.6-1.5mg Changes with age: Increases to 1.9mg Comments: Related to lean body mass decrease

Answer 6

Normal: 104-124 mL/min Changes with age: Decreases 10%/decade after age 40 years Comments: Used for prescribing medications for drugs excreted by kidneys

Answer 7

Normal: 62-110mg/dL after fasting; >120mg/dL after 2hrs postprandial Changes with age: Slight increase of 10mg/dL/decade after 30 years of age Comments: Diabetes increasingly prevalent; Drugs may cause glucose intolerance

Answer 8

Normal: 13-39 IU/L Changes with age: Increased by 8-10 IU/L Comments: Elevations >20% usually due to disease; elevations may be found with bone abnormalities, drugs (narcotics), and eating a fatty meal

Answer 9

Absence of symptoms or vague symptoms, Acute confusion, mild discomfort and constipation, some tachypnea and possibly vague respiratory symptoms, appendicitis pain may begin in right lower quadrant and become diffuse

Answer 10

Anorexia, vague abdominal complaints, new onset of constipation, insomnia, hyperactivity, lack of sadness

Answer 11

Hyperthyroidism presenting as “apathetic thyrotoxicosis,”i.e., fatigue and weakness; weight loss may result instead of weight gain; patient’s report palpitations, tachycardia, new onset of atrial fabulation, and heart failure may occur with undiagnosed hyperthyroidism

Answer 12

Hypothyroidism often presents with confusion and agitation; new onset of anorexia, weight loss, and arthralgias may occur

Answer 13

New or worsening back pain secondary to metastasis from slow growing breast masses or silent masses of the bowel

Answer 14

Absence of chest pain. Vague symptoms of fatigue, nausea, and a decrease in functional and cognitive status; classic presentations include dyspnea, epigastric discomfort, weakness, vomiting; history of previous cardiac failure. Higher prevalence in females versus males. Non-Q-wave MI

Answer 15

Absence of fever or low-grade fever. Malaise. Sepsis without usual leukocytosis and fever. Falls, anorexia, new onset of confusion and/or alterations and change in mental status, decrease in usual functional status

Answer 16

Absence of abdominal pain, dyspepsia, early satiety Painless, bloodless New onset of confusion, unexplained tachycardia, and/or hypotension

Answer 17

Absence of fever; mild coughing without copious sputum, especially in dehydrated patients; tachycardia and tachypnea; anorexia and malaise are coming; alteration and cognition

Answer 18

Lack of paroxysmal nocturnal dyspnea or coughing; insidious onset with changes in function, food or fluid intake, or confusion

Answer 19

Hepatosplenomegaly, abnormalities and liver function tests and anemia

Answer 20

Absence of fever, worsening mental or functional status, dizziness, anorexia, fatigue, weakness

Answer 21

``` S: sleep disturbances P: Problems with eating or feeding I: incontinence C: confusion E: evidence of falls ```

Answer 22

Early detection and correction of problems such as sensory deficits, confusion, and gait/balance issues can increase independence and longevity among the elderly

Answer 23

A state of unclear thinking caused by delirium and dementia Delirium is a state of mental confusion that develop suddenly and can fluctuate over time ``` D: drugs E: electrolyte imbalance L: lack of drugs (withdrawal, uncontrolled pain) I: infection (often UTI) R: reduce sensory input (vision or hearing loss) I: intracranial (CVA or subdural) U: urinary retention or fecal impaction M: myocardial/pulmonary ```

Answer 24

Young-old: 65-74 years Old: 75-84 years Oldest-old: 85 years and older

Answer 25

Younger adults: Late teens to 20s A regular course which tends to generalize hereditary factors Older adults: 50s: Males 60s: Females Sporadic onset

Answer 26

Younger adults: 20-40 years old Right lower UC ``` Older adults: > 60-75 years old a second peak occurs more often older women proctitis Left-sided UC higher rates of anemia may present as chronic diarrhea fistula development increased cases of associated malnutrition extraintestinal manifestations include arthritis spondylitis, Uveitis, and erythema nodosum, More comorbid conditions may be confused with other forms of colitis ```

Answer 27

Younger adults: 20-30 years old Older adults: >50 years old

Answer 28

Younger adults: Possible infectious ideology Older adults: Increased mortality

Answer 29

Young adults: Women 20-40 years old More thymus abnormalities ``` Older adults: Men 50-70 years old Woman 70 years old Dysphonia More frequent ocular form MG Increased rate of ACHR seropositivity ```

Answer 30

To maintain the flexibility necessary for a regular physical activity in daily life, older adults should perform activities that maintain or increase flexibility on at least 2 days each week for at least 10 minutes each day

Answer 31

Walking, aquatic activities, tai chi, resistant exercises, cycling Vary type and intensity to avoid over stressing joints; heated pool

Answer 32

Walking, treadmill walking, cycle ergometry Supervised program with BP and HR monitoring

Answer 33

Walking, treadmill walking, cycle ergometry Individualized to client; supervised program

Answer 34

Resistive, aerobic, aquatic, recreational activities Proper shoe fit; may need insulin reduction if insulin dependent

Answer 35

Walking, biking, weightlifting If able to do high intensity exercise, this benefits anxiety

Answer 36

Walking, cycling, recreational activities Group participation helpful to keep patient engaged

Answer 37

Aerobic, aquatic therapy, strengthening, tai chi, Pilates Heated pool, gentle stretches, counsel about possible increased pain initially

Answer 38

Cycle ergometer, treadmill walking: individualize Supervised program-consider pulmonary rehab program

Answer 39

Walking, standing exercises Supervised programs

Answer 40

Weight-bearing exercises, weight training Assess balance and risk for falls before beginning

Answer 41

Walking, treadmill walking, stationary bike, dancing, tai chi, Pilates, boxing Assess balance and risk for falls before beginning; American Parkinson’s disease Association resource

Answer 42

Lower extremity exercises, treadmill walking, walking Very short intervals initially, progress as tolerated

Answer 43

Tai chi, walking, aquatic therapy, biking Assess balance and risk for falls before beginning

Answer 44

Walking, recreational activities Provide safe environment, assess fall risk and ability to participate Testing prior to exercise initiation Recommended testing prior to exercise initiation

Answer 45

Assess balance and risk for falls

Answer 46

Lack of time, perceived need for equipment, perceived barrier to begin exercise/physical activity, disability or functional limitation, unsafe neighborhood or weather conditions, no park or walking trails, depression, high body mass index, lack of motivation, enter personal loss or significant life event, ignorance of what to do

Answer 47

Social support, positive self-efficacy, Motivation to engage in physical activity, good health, no functional limitations, frequent contact with prescriber, regular schedule, plan program, satisfaction with program, insurance incentive, improvement in mobility or health condition, staff

Answer 48

Unstable angina, uncompensated heart failure, severe anemia, and controlled blood glucose, and stable aortic aneurysm, uncontrolled hypertension or tachycardia, severe dehydration or heat stroke, low oxygen saturation

Answer 49

Recommended annually for all adults over 50 years old Unless contra indicated. Patients with a severe egg allergy or severe reaction to the influenza vaccination in the past with prior history of Guillain-Barré syndrome to talk to the healthcare provider before getting the vaccination

Answer 50

Once in a lifetime booster to adult then TD booster every 10 years

Answer 51

PCV 13 at the age of 65 | PPSV23 12months after PVC 13

Answer 52

Recommended for a high-risk person(I.e. Drug users, sexually active with multiple partners, living with someone with chronic happy, patients less than 60 years old with diabetes, and all desiring protection from Hep B) The initial dose is given followed one month later by second dose then their dose is given for six months after the second

Answer 53

Administered and two doses Second dose is given 2 to 6 months after initial dose Persons who have had zostavax immunizations with shingrix

Answer 54

Greater than 50 years old

Answer 55

15-65 years old

Answer 56

Greater than 18 years old

Answer 57

All adults

Answer 58

Greater than 18 years old

Answer 59

40-70 years old who are overweight or obese

Answer 60

Who all is met: 40-75 years old One or more risk factor for CVD (Dyslipidemia, diabetes, hypertension, or smoking) Calculated 10 year risk of cardiovascular event of 10% or greater

Answer 61

One time but ultrasound in men aged 65 to 75 years old who have ever smoked

Answer 62

All adults, refers BMI is greater than 30 or higher to intensive multi component behavioral interventions

Answer 63

Biennial for women age 50 to 74 years old

Answer 64

Older adults

Answer 65

Women age 65 and older Younger women whose fraction race is equal to or greater than that of a 65-year-old white woman who has no additional risk factors

Answer 66

Older adults

Answer 67

Starting at age 50 and continuing until age 75

Answer 68

Patients with chronic disease that as well managed at home may decompensate and foreign environments because of heat, humidity, altitude, fatigue, changes in diet, and exposure to infectious diseases. Fever is not always reliable indication of illness and older adults Seroconversion rates decrease with age, rendering some vaccines less effective for older travelers

Answer 69

All immunizations should be current: influenza, pneumococcal, TD/Tdap, zoster, and for some hepatitis B vaccination. Yellow fever and herpes Oster are the only life virus vaccines that people over the age 50 receive. A man response can be impaired if live virus vaccines are given within a 28 to 30 day interval from each other If a patient is required to have a yellow fever vaccine for travel, they can’t enter a yellow fever county until 10 days after receiving the yellow fever vaccine. The most common vaccine used for protecting travelers are hepatitis A, hepatitis B, typhoid fever, yellow fever, adult booster polio, Japanese encephalitis, meningococcal, and rabies

Answer 70

Physical health is related to psychosocial, functional ability and safe environment Most beneficial for the vulnerable, older adult

Answer 71

Physical health History taking, physical exam, diagnostics, nutritional assessment, medication review (Cc, HPI, past history, family and social history, and ROS)

Answer 72

Functional health ADLs, instrumental activities of daily living, sensory assessment (hearing, vision) can I gait and balance Purpose determines how the older adult can care for themselves on a day-to-day basis Any change in function is often the first and only sign of a new or changed disease process (The Katz activities of daily living scale)

Answer 73

Psychological health Cognitive disorders (delirium, dementia, mild cognitive impairment), Affective disorders (depression, anxiety), Spiritual well-being (MMSE, Montreal cognitive assessment (MoCA), and St. Louis University mental status examination (SLUMS))

Answer 74

Socioenvironmental support and quality of life measures Socioenvironmental: social network and support (The medical outcomes study—short-form 36) Supports: A living situation, environmental safety, economic resource (lubben social network scale) Quality of life measures: physical conditions, social conditions, environmental conditions, personal resources (mental health, life perspective), Preferences for care (The medical outcomes study— short-form 36)

Answer 75

Go to use for medical management of geriatric patients List of potentially inappropriate medication‘s for the elderly-listed by drug category and diagnosis List alternative drugs that can be used safely in older adults Drug to drug interactions listed, dosage for kidney impairment graded as high, medium, or low to assist with decision-making

Answer 76

Prescribing many drugs, prescribing five or more drugs, prescribing potentially inappropriate medication‘s The use of multiple pharmacies (providers and self-prescribers) Provider should routinely evaluate medication appropriateness to avoid the risk of polypharmacy

Answer 77

Have new patients bring in all medications to their first visit Review meds list at every visit Ask if any other provider has changed or added any medication‘s Update med list at every visit

Answer 78

Three available tools to evaluate patients prescriptions STOPP- screening tool of older persons potentially inappropriate prescriptions MAI- medication appropriateness index ARMOR- assess, review, minimize, optimize, reassess