2.1 Ageing

Question 1

What 3 changes occur to the respiratory system with ageing?

Answer 1

1. Lung and chest wall decreased compliance
2. TLC, FVC, FEV1 and vital capacity are all reduced as people age
3. Reduction in elastic support of the airways and leads to increased collapsibility of alveoli and terminal conducting airways

Question 2

What are common respiratory post -operative complications in the elderly?

Answer 2

Atelectasis
PE
Pneumonia

Question 3

What elderly patients are at increased risk of age related respiratory problems?

Answer 3

Smokers
Patients with chronic chest disease
Abdominal or thoracic surgery

Question 4

Why might the upper airway collapse in the elderly?

Answer 4

A

Question 5

WHAT FACTORS INCREASE THE RISK OF UPPER AIRWAY COLLAPSE IN THE ELDERLY

Answer 5

H

Question 6

What differences in skin occur in the elderly?

Answer 6

G

Question 7

Why are skin changes clinically significant in elderly patients?

Answer 7

G

Question 8

What happens to blood vessels during ageing?

Answer 8

Large and medium Vessels become more stiff, less compliant

Question 9

What is the clinical significance of CVS changes in the elderly?

Answer 9

Raised systemic vascular resistance
Hypertension
Left ventricular strain
Left ventricular hypertrophy

Question 10

What is lone AF?

Answer 10

H

Question 11

Why are heart blocks/ectopic beats/arrhythmias/AF more likely in elderly?

Answer 11

Reduced number of cardiac conducting cells

Question 12

Elderly patients are likely to suffer from AF. Since atrial contraction contributes approximately to one third of the volume towards normal ventricular filling. Therefore these patients can suffer with a reduction in CO of about 30%. How does this reduced CO manifest?

Answer 12

Dizzy
Shortness of Breath
Tachycardia - palpations
Asymptomatic

Question 13

How much does CO fall by per decade?

Answer 13

J

Question 14

Why does CO fall gradually over our lifetime?

Answer 14

J

Question 15

How does the dosage of IV anaesthesia change with age and why?

Answer 15

G

Question 16

How is glomerular filtration rate affected with age?

Answer 16

H

Question 17

Why do we see a decline in GFR with age?

Answer 17

B

Question 18

What factors contribute to a reduction in renal function with age?

Answer 18

F

Question 19

Males are more prone to to experience urinary symptoms. Why?

Answer 19

H

Question 20

How is the CNS affected during ageing?

Answer 20

F

Question 21

How does basal metabolic rate vary with age?

Answer 21

V

Question 22

How is thermoregulation control vary with age?

Answer 22

H

Question 23

Why is focusing on one body system not appropriate in elderly patients

Answer 23

B

Question 24

Why do many older peoples mental functions deteriorate rapidly when they are rehoused?

Answer 24

H

Question 25

Describe the location of care of dementia patients?

Answer 25

H

Question 26

Why does care of malnourished elderly patients cost twice as much as obesity in elderly patients?

Answer 26

• Malnourished patients are likely to have longer hospital admissions
• They respond less well to treatment, are 3 times more likely to develop complications after surgery and have higher mortality rates.
• It is recognised that over 40% of patients are malnourished on admission to hospital and nutritional risk increases during their stay.
• more fragile skin. More prone to pressure sores