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Apex Review > Geriatrics 3 > Flashcards

Geriatrics 3 Flashcards

1
Q

Which factor is unchanged in the geriatric patient?
a. creatinine clearance
b. serum creatinine
c. glomerular filtration rate
d. aldosterone

A

b. serum creatinine

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2
Q

GFR __________________ after age 40

A

decreases by 1 mL/min/year

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3
Q

What happens to renal blood flow as we age?

A

decreased

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4
Q

What happens to renal mass as we age?

A

decreased

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5
Q

What happens as response to antidiuretic hormone as age?

A

decreased

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6
Q

What happens as response to aldosterone as we age?

A

decreased

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7
Q

What happens to creatinine clearance as we age?

A

decreased

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8
Q

What happens to response to acid load as we age?

A

decreased

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9
Q

____________ is a poor indicator of renal function in the elderly

A

Serum creatinine

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10
Q

Renal blood flow decreased by __________ per decade

A

10%

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11
Q

Decreased renal mass results in

A

impaired ability to concentrate urine

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12
Q

_____________ is the most sensitive indicator of renal function and drug clearance in the elderly

A

creatinine clerance

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13
Q

Consequences of reduced GFR in the elderly include

A

increased risk of fluid overload
decreased elimination of hydrophilic drugs

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14
Q

Decreased aldosterone in the elderly patient leads to

A

decreased ability to conserve sodium and increased risk of dehydration

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15
Q

The following decrease as a normal response to aging EXCEPT:
a. albumin
b. pseudocholinesterase
c. alpha-1-acid glycoprotein
d,. hepatic blood flow

A

c. alpha 1 acid glycoprotein

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16
Q

What happens to hepatocellular function as we age?

A

no change

17
Q

What happens to hepatic mass as we age?

A

decreased

18
Q

What happens to hepatic blood flow as we age?

A

decreased

19
Q

What happens to perioperative hepatic function as we age?

A

decreased

20
Q

What happens to albumin production as we age?

A

decreased

21
Q

What happens to pseudocholinesterase production as we age?

A

decreased

22
Q

What happens to alpha-1-acid glycoprotein production as we age?

A

increased

23
Q

what happens to phase 1 & 2 reactions as we age?

A

phase 1- decreased
phase 2- no change

24
Q

What happens to first pass metabolism as we age?

A

decreased

25
Q

Increased alpha 1 acid glycoprotein production leads to ______________ in the elderly whereas decreased albumin production leads to ________ in the elderly

A

increased reservoir for basic drugs; decreased reservoir for acidic drugs

26
Q

How does aging affect the pharmacokinetics of anesthetic drugs? (select 2)
a. faster induction with etomidate
b. faster induction with sevoflurane
c. increased volume of distribution of propofol
d. increased volume of distribution of rocuronium

A

b. faster induction with sevoflurane
c. increased volume of distribution of propofol

27
Q

Describe the circulation time as we age?

A

increased

28
Q

Describe the total body fat as we age?

A

increased

29
Q

Describe the lean body mass as we age?

A

decreased

30
Q

Describe the plasma protein binding as we age?

A

decreased

31
Q

Describe the rate of recovery from volatile anesthetics as we age.

A

proloned

32
Q

Describe the surface area to body mass ratio as we age.

A

increased

33
Q

Describe IV induction vs. inhalation induction in the elderly patient.

A

IV induction- prolonged
inhalation induction- faster

34
Q

The elderly patient has a small volume of distribution for

A

hydrophilic drugs

35
Q

Age does not affect pharmacodynamic effects of __________ but the duration of _____________ is increased if _____–

A

neuromuscular blockers; steroidal NMBs if renal or hepatic clearance is reduced

Apex Review (224 decks)

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