2. Aging Flashcards
(92 cards)
1
Q
Define aging
A
cells tissues and organs may vary in age related change in the same person but are ultimately connected
2
Q
Life span when expressed as expectancy from 65 (has/hasn’t) changed very much
A
hasn’t
3
Q
Mortality is commonly caused by
A
some disease or disease process (bodies ability to withstand these diseases at
4
Q
Lifespan is expressed as
A
life expectancy from birth or a latter age
5
Q
T/F Max life-span has changed little
A
t
6
Q
Currently the maximum verifiable lifespan is how old
A
122
7
Q
Max lifespan reaches an asymptote at what age
A
115
8
Q
Prove that there is a genetic link to lifespan
A
- Hybrid vigor (increased longevity in hybrids)
- Parental age (parents live long you will likely as well)
- Twin studies (less of a difference in lifespan between monozygotic compared to dizygotic twins)
9
Q
Werner’s syndrome is what type of disease
A
premature aging syndrome
10
Q
Inheritance pattern of Werner’s syndrom
A
autosomal recessive
11
Q
Characteristics of Werner’s syndrome
A
- Growth retardation during teens
- Short
- Premature graying and hair loss
- Thin skin
- Osteoporosis
- Atherosclerosis
12
Q
Functions that predictably decline with age related to the oral cavity
A
- Swallowing
- Tongue function
- Taste acuity for salt, bitter and umami
13
Q
Other functions that predictably decline with age are
A
- Vital capacity
- Cardiac output
- Renal plasma flow
- Glomerular filtration rate
- Grip strength
- Reaction time
14
Q
Functions that don’t change with aging are
A
- pH and electrolyte content in blood
- Verbal intelligence (unless dementia)
15
Q
The rate of yearly loss seems to be -% of the functional capacity present at age 30
A
0.8-0.9%
16
Q
Mortality doubles every _ (time) after age 30
A
7 yrs
17
Q
A risk factor for most diseases is
A
aging
18
Q
What is the Hayflick limit
A
a principle related to dividing cells stating that the mother cell can only produce so many daughter cells until there is a cap
19
Q
When cell in the human body has a hayflick limit that is related to age
A
fibroblasts (have an average of 50 population doublings before a sharp decline in proliferation)
20
Q
Describe the telomere theory
A
-Everytime a cell replicates a part of the telomere on the end of DNA is lost and one it is gone replication can no longer occur due to cell damage
21
Q
What cells are exempt from the telomere theory and why
A
cancer cells and germ cells because there is a telomerase enzyme
22
Q
When telomerase is active the telomers are (degraded/maintained)
A
maintained (just like the vitality of the cells)
23
Q
Describe the free radical theory
A
-As a cell ages the number of free radicals increase which cause damage to cell membranes and create cellular waste which accumulates
24
Q
Describe the cell membrane theory
A
As a cell ages the membrane becomes less lipid and less watery (more solid)
- Cell loses ability to transfer chemicals, electrical charge
- Toxic accumulation of lipofuscin which we se in brain, heart, lung and skin
25
Explain the mitochondrial decline theory
- ATP can't be stored in the body
- Organs and cells can't transfer ATP from each other
- As free radical damage occurs to mitochondria they produce less ATP
26
Describe the glycosylation theory
- AKA cross linking theory
- Binding of sugar to protein occurs in presence of oxygen (a potent free radical)
- Causes cell to loose elasticity due to glycosylation which increases stiffness in skin, BVs, etc.
27
Describe cross-linking theory
- Postulates that aging causes by molecules becoming irreversibly immobilized by cross- linking
- Cross-linking of collagen which makes up 25% of bodies protein
- Cross-linking theorized to affect the flow of nutrients and waste products from cells
28
Describe the neuroendocrine theory
- Hypothalamus is damaged over time by cortisol secreted by the adrenal gland
- Cortisol is linked to stress and is one of the few hormones which increases with age
- Receptors that uptake various hormones lose their sensitivity
- Cascade effect leads to multiple diseases seen in later age
29
Calorie restriction can (increase/decrease) aging process
decrease (mechanism= unknown)
30
Describe the evolution theory
organisms only needed to survive long enough to reproduce and care for their offspring (before medical advances)
31
The biologic clock theory is dictated by what two events
- Puberty
| - Menopause
32
SIR2 gene is present in (few/some/many/all) organisms
all
33
SIR gene encodes _ proteins which are found where
sirtuins found in red wine
34
The presence of sirtuins found in red wine is significant why
because the french live longer and their diet is rich in high fat and red wine
35
Rapamycin is what kind of drug
antifungal agent - also can be used to suppress immune system in transplant patients
36
Rapamycin influences the ways cells respond to what
insulin and IGF
37
What is IGF
insulin growth factor
38
Rapamycin increases or decreases life span
increases (goes back to calorie restriction
39
IGF (promotes/inhibits) cell dividion and growth
promotes
40
When food is plentiful insulin and IGF (increase/decrease)
increase
41
FOXO gene is involved in
regulating the insulin/IGF pathway
42
Mutations in FOXO gene has lead to (increased/decreased) life span
increased
43
More diseases in older people, what is causing the killing the diseases or the age
the age because the same diseases in younger people typically aren't lethal (i.e pneumonia)
44
What disease causes the most death in older people
heart disease
45
Skin changes related to aging: what skin ages most rapidly and why
face and hands due to exposure
46
Skin thickness (increases/decreases) after 60
decreases
47
Look at slide 42 for histologic changes in skin
ok
| -atrophy, fewer fibroblasts, fewer BVs, etc.
48
Dental issues associated with skin changes in elderly
- Acintic elastosis
- AKA senile elastosis or solar elastosis
Skin is wrinkled dry and atrophic and flaccid
Vermillion border of lip not sharp
May be premalignant
49
During aging muscle mass (increases/decreases) body fat (increases/decreases) total body water (increases/decreases)
decreases...increases... decreases
50
Describe how changes in body fat and water content with aging affects drug metabolism
Fat soluble drugs
- I.e diazepam
- Prolongs the action of the drug
- Decreased initial effect
Water soluble drugs
- I.e acetaminophen
- Exaggerated initial effect
- Decreased duration
- Reduce the dose in older people
51
Baroreflex sensitivity (increases/decreases) with age leading to what consequences
decreases
- Increased orthostatic hypotension
- Decreased thermoregulation
52
Aortic and carotid chemoreceptor sensitivity (increases/decreases) in eldery
decreases
53
Caution with what types of drugs in older patients
-Anti-cholinergics (such as anti-depressants, anti-histamines, cold remedies, and anti-psychotics)
54
Heart becomes (more/less) compliant with age due to.... which can cause
less.... increased CT this can cause pulmonary congestion (differs from traditional heart failure)
55
T/F Digoxin a drug typically used in patients with heart failure is effective in patients with congestive heart failure caused by fibrosis
f
56
Treatment for patients with heart failure caused by fibrosis is
diuresis and control of coexistant hypertension
57
The valves in the heart most commonly affected by degenerative changes with aging are
aortic and mitral valves
58
The most common cause of aortic stenosis for the first time in a 60+ year old is
degeneration of a normal aortic valve
59
Older people with valvular disease are more prone to what other disease
atrial fibrillation
60
Atrial fibrilation is an important cause of
congestive heart failure and increased risk for stroke
61
People with arrhythmias that are older often require _ and are treated with what types of meds to prevent _
pacemakers... anticoagulants to preven thrombosis and embolism
62
Most important pre-disposing factor to endocarditis is
previous disease
63
T/F Most people diagnosed with endocarditis are 60 +
t
64
prior to surgical treatment a pateitn on anticoagulants must have an INR
3
65
T/F Generally a good ideal to get patients off their anticoagulants before surgery
f
66
Drugs to be aware of if the patient has ventricular arrhythmia is
amiodarone
67
Caution when prescribing patients with ventricular arrhythmias with _ because...
anti-fungals may prolong the QT interval potentially leading to malignant arrhythmias
68
Caution using what instruments on patients with ventricular arrhythmias
ultrasonic and electrosurg in patients with pacemakers and defibrillators
Also avoid epi
69
T/F Patients with endocarditis do not need to premed before dental appointments
f
70
Why should patients with endocarditis have spaced out dental appointments?
allow time for antibiotic pre-med to clear to avoid drug resistance Other way to prevent resistance is alternate amoxicillin and clindamycin
71
Elasticity of lungs (increases/decreases) with aging
decreases
72
T/F Oral organisms may contribute to pulmonary infection in elderly
t- more at risk for lung infection pneumonias in older people often caused by oral microbes (significant cause of mortality for institutionalized elders)
73
Preventing pneumonia caused by oral microbes can be done by...
- Eliminate gross caries
- Reinforce OH
- Anti-bacterial rinse
74
GI changes with aging: (increases/decreases) parietal cell function
decreased
75
Gastric pH (increases/decreases) with age
increases
76
Gastric emptying rate (increases/decreases) with age
decreases
77
Splanchnic blood flow is (increases/decreases) with age
decreased
78
Absorptive surface of GI (increases/decreases) with age
decreases
79
GI changes in elderly affect what regarding drugs
decreased absorption of most drugs given orally
80
GFR in elderly (increases/decreases)
decreases
81
Number of glomeruli in elderly (increases/decreases)
decreases
82
Abilities to concentrate urine in elderly (increases/decreases)
decreases
83
Inability to concentrate urine effectively in elderly puts them at greater risk for
dehydration
84
After 40 liver mass decreases by about _% each year
1
85
Reduction in liver mass results in what changes
lower plasma albumin levels, decreased microsomal enzyme acivity and slower hepatic flow
86
Reductions in plasma albumin has what consequences with drugs
greater amounts of free or unbound drug which can cause a greater drug effect
87
IGF levels in elderly (increases/decreases)
decrease
88
Glucose tolerance in elderly (increases/decreases) as a result of
decreases... as a result of insulin increase
89
IGF supplements results in what bodily changes
0leaner body mass
| -Fat mass decreases
90
Levels of NE, insulin and parathyroid hormone (increases/decreases) in elderly
increase
91
T/F Pre-med is indicated for diabetics
DEPENDS- if the patient is poorly controlled YES if well-controlled NO
92
Difference in hematocrit and hemoglobin in elderly
women= increase
Male = decrease
**This is because with age marrow fat increases leading to decrease in active marrow but in women after menopause red blood cell mass increases
**No real significant changes in hematocrite, hemoglobic, WBC, or platelet count**
