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mski > SPECONLEC_S1_L3 - P14-P29 > Flashcards

SPECONLEC_S1_L3 - P14-P29 Flashcards

1
Q

Reaction to drugs is always the same as in younger
age groups t or f

A

f, Reaction to drugs not always the same as in younger age groups

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2
Q

MEDICATION METABOLISM: Adverse effects
more frequent and may be more severe t or f

A

t

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3
Q

adipose tissue causes larger
volume of distribution for fat-soluble drugs

A

inc

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4
Q

increased adipose tissue leads to _

A

prolonged biologic
half-life

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5
Q

More diffused in the body for meds means

A

more fat stored in the body

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6
Q

Decreased total body water means that the meds are_

A

decreased volume of distribution of water-soluble

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7
Q

Since the hydration is low, you would expect
(inc or decrease) volume of water

A

decrease

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8
Q

low hydration means there will be
concnetration of drugs

A

higher

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9
Q

more concentrated drug means _

A

more potency and adverse effects of drug

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10
Q

Hepatic drug clearance decreased up to what percent

A

30%

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11
Q

Renal clearance decreased up to what percemt

A

50%

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12
Q

decrease in renal and heaptic clearance means that _

A

longer duration of drug in the body

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13
Q

GAIT: speed,
double limb support, stride length

A

dec, inc, shorter

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14
Q

gait is affected by:

A

vision,
cognition,
motor control,
balance,
peripheral sensation,
strength,
joint health,
metabolic demands

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15
Q

predictor of survival, possibly a biomarker of
health status in older adults

A

Gait speed

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16
Q

If able to walk faster > what are the chances of survival

A

more chances of survival

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17
Q

If slower than normal >what can be the prognosis

A

poor prognosis

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18
Q

Indicators of gait speed: what are the OMTs to be used

A

6-minute walk test
(6MWT)

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19
Q

gait speed that has relatively good function

A

1.0 m/sec

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20
Q

gait speed for predicitng median life expectancy for age &
sex

A

0.8m/sec

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21
Q

CONDITIONS & DISEASES IN THE ELDERLY (16)

A

frailty
disuse and immobilization
falls
osteoarthritis
osteopenia and osteoporosis
hip fx
stroke
TBI
SCI
dementia
delirium
normal pressure hydrocephalus
parkinson disease
amputation
cancer
polypharmacy

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22
Q

Age and disease-related loss of adaptation, such that
events of previously minor stress result in disproportionate
biomedical and social consequences

A

FRAILTY

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23
Q

Clinical Syndrome for frailty (5) (US WSL)

A

○ Unintentional weight loss of at least 10 lb over the
past year
○ Self-reported-exhaustion
○ Weakness (grip strength)
○ Slow walking speed
○ Low physical activity

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24
Q

Clinical Syndrome should have how many to be considered
as frailty

A

3 or more

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25
Q

frailty can be attributable to _ _ _

A

aging, diseases, and comorbidity

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26
Q

Exacerbates decline in body systems

A

DISUSE AND IMMOBILIZATION

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27
Q

DISUSE AND IMMOBILIZATION is a combination of
_ + _

A

inactivity, lack of mechanical loading

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28
Q

Combination of inactivity and lack of mechanical loading
lead to _

A

negative effects of bed rest

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29
Q

what will pt lose if he is predosposed to
disuse and immobilization

A

● Loss of muscle mass
● Loss of strength and power

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30
Q

disusue and immobilization:
muscle insulin resistance

A

increased

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31
Q

disusue and immobilization:
bone loss

A

increased

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32
Q

disusue and immobilization:
pulmonary function and exercise capacity

A

decreased

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33
Q

Inability of blood vessels to adapt

A

OH

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34
Q

there is _ venous return in OH

A

low

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35
Q

Impaired balance and coordination for disuse and immob
t or f

A

t

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36
Q

Increased/decreased risk for pressure ulcers for disuse

A

increased

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37
Q

Low nutrition can contribute to pressure ulcers t or f

A

t

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38
Q

Immobility from bed rest, predictor of decline in ADLs,
institutionalization & death in hospitalized older patients

A

DISUSE AND IMMOBILIZATION

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39
Q

as you age, there’s lower physiological capacity is lower t or f

A

t

40
Q

Major cause of morbidity

A

falls

41
Q

falls causes the majority of fx of the _ _ _

A

foreamr, pelvis, hip

42
Q

Risk factors for falls in the elderly (8)

A

○ Age
○ Physical impairments
○ Cognitive impairment, dementia, depression
○ Previous falls
○ Medications
○ Comorbid conditions
○ Chronic pain & arthritis
○ Poor functional status

43
Q

RECOMMENDATION for fall and injury prevention
in the elderly (9)

A

● Fall risk assessment by qualified healthcare
professionals or teams
● Individualized, group, and home-based exercise
● Balance, strength, & gait training exercise (e.g tai chi)
● Home safety evaluations and modifications
● Medication review and reduction program with family
physician & patient involvement
● Careful, medically directed tapering of high-risk medications
● Addressing foot/ankle pain and dysfunction
● Treating vitamin D deficiency (at least 700 international units per day)
● Cataract surgery and dual chamber cardiac pacing if indicated.

44
Q

in treating vitamin D deficiency, how many
international units per day

A

at least 800 internaltional units per day

45
Q

Criteria for falls

A

berg balance scales

46
Q

OSTEOARTHRITIS is common amoong older adults t or f

A

t

47
Q

Most common affected in OA

A

hands and knees

48
Q

what are the signficant source of pain and disabilitty for OA

A

hips and spine

49
Q

_ can lead to spinal stenosis which can
cause _

A

Disc desiccation,nerve root impingement

50
Q

Risk factors. for OA (4)

A

obesity, genetics, inadequate nutritional content, muscle strength

51
Q

Low bone density

A

OSTEOPENIA AND OSTEOPOROSIS

52
Q

OSTEOPENIA AND OSTEOPOROSIS is more comon in _

A

postmenopausal women

53
Q

men can also get osteopenia or osteoporosis t or f

A

t

54
Q

inc or dec? risk for fractures leading to pain, immobility, and
functional dependence

A

increased

55
Q

bone mineral density score -01.0 and 2.5

A

Osteopenia

56
Q

bone mineral density T score -2.5 or less

A

Osteoporosis

57
Q

Risk factors for osteopenia and osteoporosis

A

increasing age, family hx, glucocorticoid therapy, smoking

58
Q

HIP FRACTURES are also more common in older adults t or f

A

t

59
Q

hip fx is associated with _ _ _

A

increased mobility, mortality, and health
care use and cost

60
Q

HIP FRACTURES result in _ _

A

long-term disability and increased functional
dependence

61
Q

Not all elderly are recommended for hip arthroplasty t or f

A

t

62
Q

Risk factors for hip fx

A

falls, associated risks of falls, osteoporosis, skeletal fragility

63
Q

Rehab should emphasize weight-bearing as soon as possible with
goals of pain control & early loading while avoiding fracture
dislocation & implant failure t or f

A

t

64
Q

Rehab should emphasize _ as soon as possible with goals of pain control
& _ while avoiding fracture dislocation & implant failure

A

WB, early loading

65
Q

Leading cause of acute neurologic admissions to hospitals and death

A

stroke

66
Q

Health outcomes are worse among older adults because of
age-related comorbiditiess and frailty

A

STROKE

67
Q

Rehab begins in the _ setting for stroke

A

acute

68
Q

what interventions for stroke?

A

Strengthening, ROM, spasticity management, low-vision, cognitive, and urinary incontinence interventions can be performed

69
Q

Risk factors for stroke:

A

previous stroke, transient ischemic attack (TIA), HtN, hyperlipidemia, heart disease, DM

70
Q

TRAUMATIC BRAIN INJURY: age

A

> 75 y/o

71
Q

highest incidence of hospitalizations and death is d/t _

A

TBI

72
Q

traumatic brain injury is more attributable to _ than MVA

A

falls

73
Q

_ outcomes assoc. with increasing age for TBI

A

poorer

74
Q

Risk factors for TBI

A

physical and cognitive impairments

75
Q

Loss of bone mass and changes in body composition increase risk for _

A

SCI

76
Q

Traumatic SCI likely d/t _

A

falls

77
Q

Nontraumatic SCI attributable to _

A

cervical or lumbar
spinal stenosis

78
Q

Nontraumatic SCI attributable to cervical or lumbar
spinal stenosis d/t

A

degenerative joint processes disc herniation, or mass effect from
hematoma or tumor growth

79
Q

Spinal stenosis is degenrative t or f

A

t

80
Q

First-year survival is bad in SCI t or f

A

f, First-year survival is good

81
Q

Mortality rates increase dramatically with age in SCI t or f

A

t

82
Q

Group of symptoms that affect the patient’s daily function

A

DEMENTIA

83
Q

dementia affects

A

Executive cognitive dysfunction, memory impairment, mood,
personality, and behavior changes

84
Q

Reversible causes of dementia

A

SDH
NPH
depression,
hormonal imbalances,
drug and alcohol abuse,
vit D Deficiency

85
Q

Irreversible causes of dementia

A

alzheimer’s,
parkinson’s,
huntington’s disease,
AIDS,
repeated neurovascular insults,
severe or repetitive TBIs

86
Q

Early identification for dementia is critical t or f

A

t

87
Q

Mild cognitive impairment (MCI), clinically identifiable precursor to AD

A

DEMENTIA

88
Q

dementia isnt noticed immediately t or f

A

t

89
Q

Hallmark of Alzheimer’s:

A

plaques are seen in MRI –
point of no return

90
Q

dementia pts need to start early c increased physical activity:
how many minutes per week

A

150
mins of moderate physical activity and resistance
exercises

91
Q

Acute neurocognitive disorder

A

DELIRIUM

92
Q

delirium is _ and _

A

transient, reversible

93
Q

delirium occurs more commonly among the elderly t or f

A

t

94
Q

Diagnostic criteria of delirium

A

○ Disturbance in attention and awareness that develops over a short period of time and waxes and wanes during the course of the day
○ Disturbances in cognition
○ Disturbances in attention and cognition are not
better explained by a pre-existing neurocognitive
disorder
○ Evidence that the disturbance is directly d/t a
pathophysiologic process such as a medical
condition or drug-related toxicity

95
Q

treatment for delirum:

A

Treatment is pharmacologic & should be referred back
to MD

mski (28 decks)

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