Age Related Systemic Changes (with Some Diseases)

Question 1

Homeostasis changes in elderly

Answer 1

• impaired baroreceptor reflex
• increased basal NE
• decreased receptor responsiveness
• decrease in C-AMP response
• decrease in thermoregulation
• decrease in thirst response

Question 2

Skin changes and increased age

Answer 2

• decrease in skin thickness
• solar lentigo
• loss of elasticity
• keratinosis
• decrease in eccrine glands output
• decrease in sebaceous glands
• decrease in moisture content
• nail changes (onychomycosis)-yellow, brittle nails
• prolonged wound healing

Question 3

Musculoskeletal changes in elderly

Answer 3

• OA
• RA
• Gout
• Osteoporosis
• decrease in muscle weight to body weight
• decrease in muscle fibers-especially type II
• enzyme systems (ATP/LDH) decrease
• cartilage loss
• bone loss

Question 4

Nervous system and elderly

Answer 4

• loss of brain weight
• blood flow decline
• scattered dendritic loss
• lipofuscin deposition
• neurotransmitter loss

Question 5

special senses and elderly

Answer 5

• presbycusis
• reduction in olfaction
• reduction in sensitivity to pain and touch

Question 6

Systolic blood pressure and age

Answer 6

Increases

Question 7

Diastolic blood pressure nad age

Answer 7

Increases until 50-59 and then decreases

Question 8

Cardiovascular disease and age

Answer 8

• increase in peripheral resistance
• systolic BP increase
• left ventricular hypertrophy
• stroke volume declines
• max HR decline
• decline in ventricular filling
• greater degree of ventricular arrhythmias
• organ specific declines in blood flow

Question 9

Ischemic stroke

Answer 9

Thrombotic

Embolic

Question 10

Hemorrhagic strokes

Answer 10

Subarachnoid

Intracerebral

Question 11

Ischemic heart disease

Answer 11

MI

Angina

Question 12

CHF

Answer 12

Among the MOST COMMON causes of hospitalizations >65

Question 13

peripheral artery disease

Answer 13

Claudication-pain in legs

Question 14

Phlebitis

Answer 14

Problem in veins, use steroids

Question 15

NYHA class I: CHF

Answer 15

No symptoms and no limitations in ordinary physical activity

Question 16

NYHA class II:CHF

Answer 16

Mild symptoms (mild shortness of breath and/or angina) and slight limitation during ordinary activity

Question 17

NYHA class III CFH

Answer 17

Marked limitation in activity due to symptoms, even during less than ordinary activity (walking short distances) comfortable at rest only

Question 18

NYHA class IV CHF

Answer 18

Severe limitations. Experiences symptoms even while at rest. Mostly bedbound patients

Question 19

BNP levels

Answer 19

• below 100pg/mL=no heart failure
• 100-300=heart failure present
• > 300=mild heart failure
• > 600=moderate heart failure
• > 900=severe heart failure

Question 20

Respiratory system and age

Answer 20

• cartilage calcifies
• decreased alveolar surface area
• loss of parenchyma elasticity
• calcification of rib articulations
• decrease in cilial response
• decrease in vital capacity
• relative respiratory alkalosis
• decrease in oxygen consumption
• stable oxygen saturation

Question 21

COPD

Answer 21

• emphysema-in smokers

- chronic bronchitis-persistent cough

Question 22

Pneumonia

Answer 22

From cold weather

Question 23

Asthma

Answer 23

Comes back when older

Question 24

TB

Answer 24

Transmits more easily in nursing homes, some with multidrug resistance

Question 25

GI system and elderly

Answer 25

- LESS CHANGES THAN ANY OTHER SYSTEM - 40% edentulous (lacking teeth) - decrease in esophageal peristalsis - gastric atrophy - 1/3 have diverticuli - transit speed is slower in the colon

Question 26

DI diseases in old

Answer 26

- GERD - gastritis - ulcers - gallstones - diverticulosis - hiatal hernia - constipation

Question 27

Liver and pancreases and old age

Answer 27

-age related hepatic and pancreatic failure do not occur 0lab tests dont change with age-SGOT, SGGT, bilirubin, ALK PHOS -drug metabolism is prolonged (BENZODIAZEPINES)

Question 28

Stage 1 renal failriue

Answer 28

Kidney damage with normal or increased GFR (>90)

Question 29

Stage 2 renal failure

Answer 29

Mild reduction in GFR (60-89)

Question 30

Stage 3 renal failure

Answer 30

Moderate reduction in GFR (30-59)

Question 31

Stage 4 renal failure

Answer 31

Severe reduction in GFR (15-29)

Question 32

Stage 5 renal failure

Answer 32

Kidney failure (GFR < 15 or dialysis)

Question 33

Renal function and age

Answer 33

- glomeruli decrease in number - sclerosis in remaining glomeruli - renal tubules decrease - createnine clearance decreases 1% per year - decreased GFR - poor response to volume depletion

Question 34

Genito urinary disease

Answer 34

Incontinence -major cause of nursing home placement UTI Chronic renal failure

Question 35

Hemopoietic system and age

Answer 35

Blood count stay stable Reserve for hemopoiesis decreases Anemia is pathology

Question 36

Anemia

Answer 36

- anemia of chronic disease-most common in most studies - nutritional - folate - iron deficiency - b12 deficiency - unexplained

Question 37

Psychological changes in age

Answer 37

- Primary (short term) memory declines - Secondary (long term) memory -intact - crystallized intelligence intact - working memory declines - attention declines - Speed of processing declines - longitudinal versus cross-sectional. Try to evaluate longitudinal studies rather than cross sectional - PERSONALITY STAYS STABLE