Wk 1: Geriatry Flashcards
Which age group is the fastest growing segment of the U.S. population?
geriatrics
Geriatrics, otherwise known as elderly, are how old?
> 65 years old
Aged persons are how old?
> 80 years old
Are autonomic nervous system responses in geriatrics enhanced or diminished?
diminished
How do you calculate cardiac output?
Cardiac Output = SV × HR
How do you calculate cardiac index?
Cardiac Index = CO / Body Surface Area (BSA)
(BSA = [Weight^(0.5)] [Height^(0.5)] / 60 m²
[weight in kg, height in cm]
Are circulation times increased or decreased with geriatric patients?
increased
you need to give lower drug doses and wait longer for their effects
When providing anesthesia for geriatrics, within what percentage of baseline do you want to keep their systolic BP?
within 20% of baseline
How is cardiac output maintained in geriatrics?
increased diastolic filling and increased stroke volume
Geriatrics have a decreased tolerance to increases in heart rate. An increase in heart rate may cause what?
myocardial infarction
Three things that decrease in regards to the cardiovascular system in geriatrics:
cardiac output
maximum heart rate
blood pressure
Three things that increase in regards to the cardiovascular system in geriatrics:
stroke volume
heart size
LVEDP (left ventricular end-diastolic pressure)
Which ECG lead is the best for ischemia detection?
V5
Do geriatrics have ventilation/perfusion mismatching?
yes, they have greater V/Q mismatching
In geriatrics, their hypoxic and hypercarbic drive can be decreased by how much?
can be decreased by half
In geriatrics, are their alveoli more or less rigid than younger patients?
more rigid
Do geriatrics need to worry about things like auto-regulation?
no, because their auto-regulation is maintained, sucka!
Do geriatrics have an increased or decreased sensitivity to pain? How about their ability to thermoregulate?
decreased sensitivity to pain
decreased thermoregulation
Do geriatrics have an increased or decreased risk of adverse drug reactions?
increased
Are the gastric secretions of geriatrics more acidic or more alkaline?
more alkaline
Contracted vascular volume can lead to what pharmacokinetic effect?
high initial plasma concentration
Decreased protein binding can lead to what pharmacokinetic effect?
increased availability of free drug
Increased total body lipid storage sites can lead to what pharmacokinetic effect?
prolonged action of lipid-soluble drugs
Decreased renal and hepatic blood flow can lead to what pharmacokinetic effect?
prolonged action of drugs dependent on kidney and liver elimination
What are some changes in pulmonary function seen with advancing age?
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
Are ECGs important preoperatively in geriatric patients?
preop ECGs are crucial for geriatrics
may detect previous MI’s, conduction issues, arrhythmias, etc.
