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ADV CLET 1 > IRAT 4 GERIATRICS/PEDIATRICS > Flashcards

IRAT 4 GERIATRICS/PEDIATRICS Flashcards

1
Q

Geriatric

A

Over 65

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2
Q

__ of most DC practices are geriatrics

A

12-15%

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3
Q

Population over 65 purchases ___ of Rx drugs

A

1/3

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4
Q

Represents 3M and is fastest growing segment of the population

A

Greater than 85

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5
Q

Average age of death is ___ in the US

A

75

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6
Q

Only ___ of geriatrics utilize DC services

A

4.6%

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7
Q

Goal of treatment of geriatrics

A

Prevent or delay functional decline and restore or maintain function to allow as much independent living as possible

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8
Q

3 categories of geriatrics

A

Young-old
Middle-old
Old-odl

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9
Q

Maintained a level of fitness that allows participation in recreational activities

A

Young-old

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10
Q

Independent with daily activities but need assistance with demanding needs

A

Middle-old

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11
Q

Require nursing care

A

Old-old

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12
Q

10 most common chronic conditions in primary care

A 
OA
Hypertension
Hearing 
Cardiac
Ortho impairment
Chronic sinusitis
Vision
Diabetes 
Varicose veins
Abdominal hernia
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13
Q

Cardiac disease, cancer, and stroke account for __ of deaths in geriatrics

A

75%

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14
Q

Suicide in geriatrics is ___ the national average

A

5x

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15
Q

Death from complications of hip fracture is ___

A

15%

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16
Q

Abrupt onset of signs and symptoms will usually represent a disease rather than

A

Normal again

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17
Q

Geriatrics often suffer side effects of

A

Multi-drug Rxs

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18
Q

Seniors have less reserve to deal with

A

Infections

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19
Q

Geriatrics are prone to

A

Depression and alcoholism

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20
Q

Often geriatrics are victims of

A

Verbal or physical abuse

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21
Q

Common musculoskeletal conditions in geriatrics

A

OA, RA, DISH, gout
Osteoporosis
Paget’s

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22
Q

Common neuro conditions geriatrics

A

Alzheimers
Parkinsons
Depression

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23
Q

Common EENT conditions geriatrics

A

Vision loss
Presbycusis
Tinnitus
Chornic sinusitis

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24
Q

Common endocrine conditions geriatrics

A

Diabetes

Hyperparathyroidism

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25
Q

Cardio/renal common conditions geriatrics

A 
CHF
MI
Hypertension
Stroke
Aneurism
Temporal arteritis
Renal failure
Incontinence
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26
Q

Common reproductive condtions geriatrics

A

Breast CA
Ovarian CA
Prostatic CA

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27
Q

Common GI conditions geriatrics

A 
Hiatal hernia
GERD
Constipation
Diverticulitis
Colorectal CA
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28
Q

Strategy for symptomatic patient evaluation

A

Most common conditions in elderly
Atypical presentations
Drug side effects or interactions
Cancer

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29
Q

Geriatrics management

A

Establish an annual physical
Provide info with regard to reducing risk of disease
Provide info with regard to falling
Provide info regarding support groups if applicable

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30
Q

For patients with a diagnosed condition managment

A

Refer to presecriber if drug related
Refer for further evaluation if necessary
Manage or comanage hypertension, obesity, diabetes, musculoskeletal conditions, pain

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31
Q

Adjusting recommendations geriatrics

A

Light force for osteoporosis
Avoid excessive rotational techniques
Avoid extreme spinal flexion with osteoporosis
Adjust headpiece for comfort
Distract joint when adjusting extremities

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32
Q

Geriatrics normal aging spine

A

Spinal canal - cord compression likely

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33
Q

Geriatrics normal aging cardio

A 
Blood vessels inc atherosclerosis/HBP
Heart - stroke volume
Resp - difficulty breathing
GI - GERD, B12
Colon - constipation
Kidney - excretion
Bladder - nocturia/incontinence
Endocrine - BPH/CA
Blood glucose - 5 mg/dL per decade after age 50
Bone - osteopenia/osteoporosis
Muscle - strength
Brain - dementia
Peripheral nerves - reaction time
Eyes/ears - acuity
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34
Q

Geriatrics normal aging eyes/ears

A

8% visually impaired
Visual impairment places pt at risk for falls, MVAs, etc
60% of patients 70+ have hearing deficit
Most common condiiton is presbycusis

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35
Q

Geriatrics radiograph

A

Value is high
Must correlate findings with complaints
Bone scans useful for primary CA or mets

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36
Q

May be the decision point for a nursing home

A

Falls

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37
Q

Leads to dependence

A

Falls

38
Q

1/3 of pts greater than 65 report __ falls per year

A

1+

39
Q

Women fall more than men. T/F

A

Ture

40
Q

Major causes of falling

A 
Accidents
Gait disturbance
Vertigo
Confusion
Postural hypotension
Visual impairment
Syncope
41
Q

Ddx requires

A

Breast and pelvic exam

42
Q

For many complaints a clinical impression may still be gained through appropriate questioning resulting in either a limited trial of treatment or

A

A referral for further testing or managment

43
Q

Public health task force on women’s health issues established

A

1983

44
Q

National institute of health (NIH) established the office of research on women’s health

A

1990

45
Q

Women’s helath initiative (WHI) was developed - this is a prevention based study

A

1991

46
Q

Women live longer than men. T/F

A

True

47
Q

On average women develop cardiac disease ___ than men

A

10 years later

48
Q

Women have a higher incidence of some sports injuries at the

A

Knee

49
Q

Women have a higher incidence of

A 
Migraine HA
Depression
Eating disorders
Urinary incontinence
Obesity
Progressive scoliosis
Osteoporosis
50
Q

Leading cause of death for women 24-34

A

Accidents
Homicide
Suicide

51
Q

Leading cause of death for women 45-54

A

Heart disease

Lung CA

52
Q

Leading cause of death in women age 65-74

A

Heart disease
Lung CA
Cerebrovascular disease
Breast CA

53
Q

Leading cause of death in women with mortality rate 5-6x higher than lung or breast CA

A

Heart disease

54
Q

Top ten CA’s in women

A 
Breast
Lung
Colorectal
Cervical
Urinary tract
Lymphoma
Melanoma
Thyroid
Ovarian
Leukemia
55
Q

Study at Creighton medical school showed vitamin D could cut the risk of CA by

A

60%

56
Q

Vitmain D3 recommended

A

Female patients

57
Q

Female patient evaluation

Screen for family hx of

A 
CA
Heart disease
Hypertension
Osteoporosis
Depression
Rheumatic disease
HA
Obesity/diabetes
58
Q

BP done every

A

2 years if normal

59
Q

Breast exam every

A

3 years for 20-39 then annually

60
Q

Mammogram every

A

1-2 years for 40-49 then annually til 69

61
Q

Pelvic exam

A

Annually

62
Q

Papanicolaou smear from 18 to sexually active then

A

Annually until 3 negative results then dr’s discretion, discontinue at 65

63
Q

Eye exam

A

1x between puberty and 40 then every 2-4 years til 64 then annually

64
Q

Fasting blood glucose every

A

3 years

65
Q

Cholesterol every

A

5 years

66
Q

Colonoscopy ever

A

5-10 years after age 50

67
Q

Skin exam by dermatologist every

A

3 years after age 40

68
Q

Female patient evaluation for the symptomatic patient

A

Consider most common conditions that are seen in females
Consider cardiac dz
Be vigilant for symptoms of abuse

69
Q

Female patient evaluation for athletic patient

A

Screen for regional weakness
Screen for joint instability
Screen for patellar tracking abnormalities
Watch for indicators of female athelte triad
Examine for nutritional deficiencies
Watch for signs of stress fx

70
Q

Female athlete triad

A

Eating disorder
Amenorrhea
Osteoporosis

71
Q

Female patient evaluation for pregnant patient

A

Reinforce need for regular prenatal chekc-ups
Counsel on avoidance of alcohol, smoking, control of diabetes, safe exercise
Monitor patient’s blood pressure
Be alert to post partum depression

72
Q

Female patient evaluation for the postmenopausal patinet

A

Pay attention to signs of osteoporosis
Screen for indicators of diminishing cognitive function
Reinforce breast CA screenings
Reinforce colon CA screenings

73
Q

For all femal patients management

A

Stress importance of monthly breast exams
Provide counseling on age-related concerns
Advice regarding exercise, nurtition, heart dz
Advise regarding osteoporosis
Modify adjusting procedures with regard to age and pregnancy

74
Q

Natual menopause represents an age-related

A

Ovarian failure

75
Q

A progressive FSH results in

A

Shorter menstrual cycles and fewer ovulations and a decrease in progesterone

76
Q

During transitional phase, referred to as the climactic or premenopausal period, frequency of bleeding is

A

Irregular and less frequent

77
Q

When menses has not occurred for one year

A

Female has reached menopause

78
Q

In USA menopause occurs on average of

A

50-51 years old

79
Q

Majority of problems occur in female athletes or with women in occupations where a thin appearnce is required

A

Eating disorders

80
Q

The 2 priamry disorders in females

A

Anorexia nervosa

Bulimia nervosea

81
Q

A disorder associated with self-imposed weight loss due to a distorted body image and other psychologically related problems

A

Anorexia nervose

82
Q

85% anorexia nervosa are

A

Young affluent white females

83
Q

Often a perfectionist

A

Anorexia nervosa

84
Q

Weight is maintainted at least 15% below that expected as normal based on height and gender

A

Anorexia nervosa

85
Q

Intense fear of gaining weight even though obviously underweight

A

Anorexia nervosa

86
Q

Distorted sense of self

A

Anorexia nervosa

87
Q

Absence of at least 3 consecutive menstrual cycles without any other known cause

A

Anorexia nervosa

88
Q

Characterized by a binge-purge cycle in order to avoid weight gain

A

Bulimia nervosa

89
Q

Seen in about 50% of AN patients

A

Bulimia nervosa

90
Q

Usually cocurs when the pt is depressed bored or lonely

A

Bulimia nervosa

91
Q

Seen in 20% of college sutdents

A

Bulimia nervosa

92
Q

4% report weekly events

A

Bulimia nervosa

ADV CLET 1 (16 decks)

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