Wk 1: Geriatry

Question 1

Which age group is the fastest growing segment of the U.S. population?

Answer 1

geriatrics

Question 2

Geriatrics, otherwise known as elderly, are how old?

Answer 2

> 65 years old

Question 3

Aged persons are how old?

Answer 3

> 80 years old

Question 4

Are autonomic nervous system responses in geriatrics enhanced or diminished?

Answer 4

diminished

Question 5

How do you calculate cardiac output?

Answer 5

Cardiac Output = SV × HR

Question 6

How do you calculate cardiac index?

Answer 6

Cardiac Index = CO / Body Surface Area (BSA)

(BSA = [Weight^(0.5)] [Height^(0.5)] / 60 m²

[weight in kg, height in cm]

Question 7

Are circulation times increased or decreased with geriatric patients?

Answer 7

increased

you need to give lower drug doses and wait longer for their effects

Question 8

When providing anesthesia for geriatrics, within what percentage of baseline do you want to keep their systolic BP?

Answer 8

within 20% of baseline

Question 9

How is cardiac output maintained in geriatrics?

Answer 9

increased diastolic filling and increased stroke volume

Question 10

Geriatrics have a decreased tolerance to increases in heart rate. An increase in heart rate may cause what?

Answer 10

myocardial infarction

Question 11

Three things that decrease in regards to the cardiovascular system in geriatrics:

Answer 11

cardiac output

maximum heart rate

blood pressure

Question 12

Three things that increase in regards to the cardiovascular system in geriatrics:

Answer 12

stroke volume

heart size

LVEDP (left ventricular end-diastolic pressure)

Question 13

Which ECG lead is the best for ischemia detection?

Answer 13

V5

Question 14

Do geriatrics have ventilation/perfusion mismatching?

Answer 14

yes, they have greater V/Q mismatching

Question 15

In geriatrics, their hypoxic and hypercarbic drive can be decreased by how much?

Answer 15

can be decreased by half

Question 16

In geriatrics, are their alveoli more or less rigid than younger patients?

Answer 16

more rigid

Question 17

Do geriatrics need to worry about things like auto-regulation?

Answer 17

no, because their auto-regulation is maintained, sucka!

Question 18

Do geriatrics have an increased or decreased sensitivity to pain? How about their ability to thermoregulate?

Answer 18

decreased sensitivity to pain

decreased thermoregulation

Question 19

Do geriatrics have an increased or decreased risk of adverse drug reactions?

Answer 19

increased

Question 20

Are the gastric secretions of geriatrics more acidic or more alkaline?

Answer 20

more alkaline

Question 21

Contracted vascular volume can lead to what pharmacokinetic effect?

Answer 21

high initial plasma concentration

Question 22

Decreased protein binding can lead to what pharmacokinetic effect?

Answer 22

increased availability of free drug

Question 23

Increased total body lipid storage sites can lead to what pharmacokinetic effect?

Answer 23

prolonged action of lipid-soluble drugs

Question 24

Decreased renal and hepatic blood flow can lead to what pharmacokinetic effect?

Answer 24

prolonged action of drugs dependent on kidney and liver elimination

Question 25

What are some changes in pulmonary function seen with advancing age?

Answer 25

central airways increase in size (leads to increased dead space)

decreased size of small airways

15% reduction in functional alveolar surface by age 70

decreased total lung capacity

Question 26

Are ECGs important preoperatively in geriatric patients?

Answer 26

preop ECGs are crucial for geriatrics

may detect previous MI’s, conduction issues, arrhythmias, etc.