Age Related Changes 2

Question 1

Effects on heart

Answer 1

Heart wall thickens
Diastolic filling rate decr
Systolic BP incr
Left ventricular mass and volume decr

Question 2

How are heart size and election fraction changed with age

Answer 2

No change

Question 3

Changes to peripheral circulation

Answer 3

Max o2 consumption decr
Beta adrenergic modulation decr
Stroke volume incr

Question 4

Why does stroke volume incr w age

Answer 4

Counteract decr heart rate

Question 5

How does age related cardiac hypertrophy differ between males and females

Answer 5

Male - eccentric hypertrophy
Female - concentric hypertrophy

Question 6

How does oestrogen decr in women with age affect cardiac hypertrophy

Answer 6

Oestrogen receptor prevents hypertrophy
Less oestrogen -> oestrogen receptor in cardiomyocytes and fibroblasts lost -> hypertrophy

Question 7

Are AAA more likely in men or women

Answer 7

Men

Question 8

How are AAAs screened

Answer 8

Ultrasound

Question 9

How are AAAs found during screening managed

Answer 9

Small - not treated
Medium - checked for size incr next year
Large - check every 3 mo or emergency referral to surgeon

Question 10

Effects on pulmonary system

Answer 10

Trachea and central airways incr in size
Chest wall thickens
Cilia nbr and activity decr
Glandular cell decr
Decr nerve endings in larynx
Decr IgA

Question 11

How are pulmonary function measurements affected with age

Answer 11

Incr residual volume
Incr anatomic dead space
Decr lung weight

Question 12

When are age related pulmonary changes noticeable

Answer 12

Exercise

Question 13

Effects of incr chest wall thickness

Answer 13

Loss of elastic recoil
Incr closing volume
Decr max expiratory flow
Incr resp failure risk

Question 14

Why is respiratory infection risk increased with age

Answer 14

Less removal of pathogens - decr cilia, decr cilia activity, decr mucus secreting cells, blunted cough reflex
Less IgA
Less neutrophil migration

Question 15

Why is the cough reflex blunted with age

Answer 15

Decreased nerve endings in larynx

Question 16

Anatomical Effects on renal system

Answer 16

Kidney size decr
Glomeruli nbr decr
Renal tube changes
Renal blood vessels get smaller and thicker
Decr renal tubular cell nbr
Thickened tubular walls
Decr GFR
incr SNGRF

Question 17

Effects of decr renal tubular cell number and incr tubular wall thickness

Answer 17

Decr ability to concentrate urine
Decr ability to clear drugs

Question 18

Functional effects on renal system

Answer 18

Decr GFR
decr renal blood flow
Decr Na conservation

Question 19

Why does Na conservation decr w age

Answer 19

Lower plasma renin activity
Urinary aldosterone excretion

Question 20

Why are renal system changes more significant in diabetes patients

Answer 20

Changes to basement membrane

Question 21

What can cause increase single nephron glomerular filtration rate with age

Answer 21

Compensatory hyper function due to loss of nephrons

Question 22

Effects of ureter, urethra, and bladder tone and elasticity loss with age

Answer 22

Incomplete bladder emptying
Decr bladder capacity - incr urination freq and urgency

Question 23

How does prostate growth effect bladder emptying

Answer 23

Compresses urethra

Question 24

Effects of age on brain

Answer 24

Decr brain mass
Decr cerebral bloodflow

Question 25

What do age related brain changes lead to

Answer 25

Decreased coordination Prolonged reaction time Short term memory impairment Decr sensory conduction time Incr BBB permeability

Question 26

Is age related decr in white or grey matter more significant

Answer 26

Grey

Question 27

Effects of increased BBB permeability

Answer 27

Easier for pathogens and drugs to reach brain

Question 28

Which hormone is effected by age

Answer 28

Serotonin - loss of receptors

Question 29

What can decreased serotonin effect

Answer 29

Pain Sleep Feeding Sexual behaviour Cardiac regulation Cognition Hemostasis GI motility Immuno modulation Antidepressants function

Question 30

Effects of ageing on vision

Answer 30

Presbyopia - lens growth and fluid loss decreases lens flexibility Decr pupil size Yellowing of lens Decr lens fluid and lens flexibility Dry eyes - lacrimal gland less effective

Question 31

Effects on liver

Answer 31

Regeneration capacity decreases Cell function decrease Size decr Lipofuscin accumulation in hepatocytes Hepatic blood flow decr Decr P450 enzymes - decr drug metabolism

Question 32

Average hepatocytes lifespan

Answer 32

150 days

Question 33

Why is the liver less effected by age than other organs

Answer 33

Regeneration

Question 34

Effects on immune system

Answer 34

Decr innate immune cell function Cell mediated response decr Humeral response decr Thymus size decr Less T cell proliferation Less antibody production Incr pro inflammatory cytokines

Question 35

Effects on innate immune cells

Answer 35

Neutrophils - decr chemotaxis, phagocytosis Monocytes/macrophages - incr pro inflam CD16+ population, decr phagocytosis Dendritic cells - decr nbr, less IL12 NK cells - function decr, decr chemokine production, nbr increase

Question 36

Effects of thymus atrophy

Answer 36

Decr naive T cells

Question 37

Effects on oral cavity

Answer 37

Xerostomia Loss of taste and smell

Question 38

Effects on stomach

Answer 38

Gastric muscle atrophy Gastric mucosa thins Elastic fibres replace smooth muscle Gastric secretion decr pH decr Gastric emptying slows

Question 39

Why is B12 deficiency more common in old age

Answer 39

Incr pH decr B12 release from food

Question 40

Why does gastric pH incr w age

Answer 40

Latent H pylori infection destroys parietal cells

Question 41

Effects on intestines

Answer 41

Decr pancreatic and gastric enzymes Constipation Fecal incontinence

Question 42

Absorption of which nutrients are impeded with age

Answer 42

Vitamin d Calcium Iron folic acid

Question 43

Why are fat, carbohydrate, and protein metabolism not effected by decreased enzymes

Answer 43

Spare capacity of enzymes

Question 44

What causes constipation and fecal incontinence with age

Answer 44

Slowed circulation Decr thirst Decr activity Slowed peristalsis from decr GI tone

Question 45

Effects on endocrine system

Answer 45

Reg and feedback mechanisms deteriorate Binding affinity and receptor decr Glucose tolerance decr Sex hormone decr

Question 46

What endocrine functions are effected by aging

Answer 46

Glucose homeostasis Reproductive function Calcium metabolism Adrenal function Thyroid function

Question 47

Hair changes

Answer 47

Epidermis thins Melanocyte decr Decr elasticity Pigment spots Easier bruising Sebaceous glands less active Less subcutaneous fat Sweat glands less active

Question 48

Hair changes

Answer 48

Grey hair - follicles produce less melanin Hair thickness decr Hair growth rate decr

Question 49

Why is bruising easier with age

Answer 49

Thinner skin Fragile blood vessels