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Older Adult Primary Care > Week 1 > Flashcards

Week 1 Flashcards

1
Q 
Age changes: prostate
Heart function
Weight
Bone density
Renal perfusion
A

Prostate- increase 100%
Max heart rate Decreases from 195 to 155 bpm
Weight decreases by 7%
Bone mineral content decreases by 10 to 30%
Renal perfusion decreases by 50%

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2
Q

Causes of age related nocturia

A

Changes in bladder physiology include decreased capacity and increased residual volume
Altered control of fluid excretion related to low nighttime ADH levels and increased nighttime natriuretic polypeptide levels

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3
Q

Frailty occurs when? 3/5

A 
Unintentional weight loss
 self-reported exhaustion 
weakness 
slow walking speed and 
low physical activity
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4
Q

Icebergs

A

Frequently and reported symptoms that are not normal response to ageing

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5
Q

Most common iatrogenic problems in geriatrics

A

Adverse drug affects, acute kidney injury, adverse surgical outcomes

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6
Q

Pneumonia vaccine schedule BC

Eligibility?

A

Conjugate 1st (ie Prevnar 13) then 8 weeks later = ppv23
ppv23 1st-wait 1 year then conjugate
Older than 65 years or high risk

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7
Q

4 As of smoking cessation approach

A

Ask, advise, assist, arrange follow-up

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8
Q 
Type of physical activity to improve:
Cardiovascular
Body comp
Metabolism
Bone health
Psychological wellbeing
A 
Aerobic activity 
Aerobic activity 
Aerobic activity
Weight bearing exercise
Aerobic
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9
Q

Indication of poor nutritional intake: BMI ? Weight loss

A

BMI ≤20

Weight loss ≥ 10 lbs in 6 months

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10
Q

Fat Dietary recommendations: sat fat? Dietary cholesterol?

A

Sat fats- 10% caloric intake?

<300mg diet cholesterol

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11
Q

Eg. Monounsaturated fat

Benefit?

A

Olive oil

Lower LDL and leave HDL intact

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12
Q

Sunflower, corn, soy beans, are examples of what fats?

What’s their impact on lipoproteins?

A

Polyunsaturated fats

Lower HDL and LDL

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13
Q

Recommended fibre intake

A

14g. per 1000 cal

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14
Q

% Of diet that should be made up of proteins

A

12-20% total cal

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15
Q

Four domains of assessment

A

Physical, functional, emotional, socioeconomic

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16
Q

Five I’s of subjective assessment

A 
Immobility
Instability 
incontinence 
intellectual impairment
iatrogenic complications
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17
Q

Name three geriatric Giants

A

Dementia, depression, delirium, incontinence, orthostatic hypotension, falls in dizziness, osteoporosis, polypharmacy, pain in the elderly, failure to thrive/frailty

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18
Q

Ultrasonography is helpful in evaluating the biliary tree, looking for urethral obstruction, evaluating vascular structures, but has limited utility in _______ patients.

A

Obese

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19
Q

Best imaging method of the brain parenchyma when used with gallium contrast

A

MRI- MR angiography

** Gallium is not nephrotoxic

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20
Q

Uses ultrasound to delineate the cardiac size, function, ejection fraction and presence of valvular disease

A

Echocardiography

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21
Q

Radio pig die injected into the various vessels and radiographs or fluoroscopic images are used to determine vascular structure, occlusion, cardiac function, or valvular integrity

A

Angiography

22
Q

Test used to test individuals at risk for coronary heart disease, monitor blood pressure, heart rate, chest pain, and ECG while increasing oxygen demands

A

Treadmill stress test

23
Q

Normal TSH level

A

0.5-5mIU/L

24
Q

New York Heart Ass functional classes

A

1- no
2- slight
3- marked
4- inability

25
Q

Normal Na and K serum levels

A

K- 3.5-5.5

Na- 135-145

26
Q

CKD - ‘normal to mild increase’ ACR level

A

<3 mg/mmol

27
Q

CKD- ‘moderately increased’ ACR

A

3-30 mg/mmol

28
Q

CKD ‘severely increased’ ACR

A

> 30 mg/mmol

29
Q

HF likely with level greater than - (>55yrs)
Nt-proBNP
BNP

A

Nt-proBNP- >300pg/ml = likely

BNP- <100pg/ml = unlikely >400pg/ml = likely

30
Q

Levothyroxine wt based dosing and follow-uptime?

A

1.6 mg/kg/d

FU- 6 weeks

31
Q

Polypharmacy is how many meds

A

≥5

32
Q

Age when stamina reduction begins

A

20 yrs

33
Q

Woman with normal paps x3 can stop @ what age

A

69yrs

34
Q

Follow up interval For men with normal PSA tests (age specific).

A

Less than two year intervals not recommended

35
Q

Mini mental status exam score of 10 to 20 means?

A

Moderate impairment

36
Q

Mini mental status exam results 20 to 25 means?

A

Mild impairment

37
Q

Mini mental status exam result 0 to 10 means?

A

Severe impairment

38
Q

Iatrogenic disease is?

A

Caused by medical intervention

39
Q

ADL mnemonic & common assessment tool

A 
D-dressing
E- eating
A- ambulating
T-toileting
H-hygiene

Katz index of independence

40
Q

IADL mnemonic and tool

A 
S- shopping
H-housework
A-accounting
F-food prep
T-transport
T-telephoning
T-taking meds

Lawton IADL tool

41
Q

Pneumovax 23- who?

Booster?

A

All over 65- covered
Or <65 and high risk
Booster after 5 years if high risk

42
Q

Prevnar13- vaccine type?
Who?
When?

A

Conjugate vaccine
High risk people often >65y
Give 8 weeks BEFORE pneumo23
Give 1 year AFTER pneumo23

43
Q

Who should get the shingles vaccine?
Coverage?
Doses?

A

> 50 at risk of shingles
2 doses, 2-6 months apart
No coverage

44
Q

When can shingrix be given IF pt had shingles or has had zostavax?
Who should get zostavax?

A

1 year after both shingles and shingrix vaccine

Those who can’t get shingrix

45
Q

MMR vaccine in olde adults?

A

Born pre 1970 considered immune- maybe get one time dose

46
Q

Breast cancer screening for average risk-
50 to 74?
>74?

A 
50-74= q2y
>74= q2-3y
47
Q

BC Cancer higher than average risk = ?

breast cancer screening- 40-74 years

A

1st degree relative with BCa

Q1year

48
Q

BC Cancer high risk?

Screening for 30-74y?

A

High risk- BCa in 1st deg relative, strong fam hx, previous chest radiation
Q1year

49
Q

Who is not eligible for mammogram? (5)

A
  1. Breast implants
  2. Pregnant/ breast feeding
  3. Previous history of breast cancer
  4. New breast complaints ie. lump/ discharged
  5. Has had mammogram on both breasts in last 12 months
50
Q

When does cervical cancer screening begin?
And what interval?
When can it stop if 3 normal results in 10 years?

A

25 y/o
Q3 years
69 y/o

51
Q

Colon cancer screening- Average risk, asymptomatic, 50 to 74 years old

A

FIT q2y

Or- colonoscopy q10y

Older Adult Primary Care (2 decks)

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