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USMLE HY notes > Aging > Flashcards

Aging Flashcards

1
Q

Whats the diagnosis?

15 yr old male, easy brusing, fatigue, nose-bleeding, stopped growing with hyperpigmented macules on upper chest and neck. oral leukoplakia, dystrophic nails.
CBC: pancytopenia

which genetic mutaiton is it:
* Fanconi anemia
* Acute lymphoblastic leukemia
* dyskeratosis congenita
* diamond blackfan anemia
* chronic grnaulomatous disease

A

dyskeratosis congenita
genetic mutation affecting telomere maintenance
» short telomeres&raquo_space; premature celldeath in rapidly dividing cells. (mucocutaneous, BM, pulmonary fibrosis)

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2
Q

what is telomerase?
what his function?

A

Ribonucleoprotein
function: adds DNA sequence repeats to chromosome ends (telomeres) = maintaning telo,ere length, particulary in stem cells.

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3
Q

how does telomerase activity differ between stem cells and somatic cells

A

stem cells- higher activity
Somatic cells- lacking telomerase&raquo_space; telomere shortning&raquo_space; higher risk for cell death

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4
Q

how does cancer cells affect telomerase activity?

A

up-regulation

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5
Q

what happens to EPO during Aging of BM

A

stay the same
altough less blood cells are produce

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6
Q

aging &acculmulaiton

what accumulate in cells with low regeneraiton capacity?

and in which cells can we see it

A

lipofuscin
(byproduct of lipid oxidation and and low lysosomal break due to free ROS)

Liver, heart, kidney, brain

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7
Q

aging

what substance accumulaiton will cause myocardial atrophy?

A

connective tissue (interstitial) + Extracellular amyolid

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8
Q

how does aging affect on immune cell divison?

on lympocytes

A

Loss lymphocytes telomere length > decrease production of naive B&T.

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9
Q

how does aging affect the division into subtypes of lympocytes?

A

less naive cells&raquo_space; those cells become more memory cells&raquo_space; less B&T for new antigens&raquo_space; Higer risk for vaccine failure & infections

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10
Q

Aging & liver

What age related changes occur in the liver affecting drug metabolism?

A
  1. reduce liver mass (lower hepatic blood flow)&raquo_space; less ability to metabolize drugs
  2. Decrease expression of CYP450
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11
Q

Does aminotransferases level changes by aging?

A

no
remain the same in helaty elderly

same for: BL, ALP, GGT

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12
Q

Aging & eyes

what is presbyopia

A

age related loss of lens elasticity, affecting near vision focus

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13
Q

what is myopia?

A

nearsightedness, impedes your ability to see distant objects clearly

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14
Q

how does presbyopia affect mild myopia?

A

adjust image focus onto the reting&raquo_space; Offsetting myopia effect

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15
Q

Aging &skin

what are UVA and UVB (UV light)

A

UVA- trigger ROS formation&raquo_space; inf. and collagen & elastin break&raquo_space; thinning and wrinkles
UVB- causing sunburn and higher risk cancer

B= באסה נשרפתי
A= אעעעע יש קמטים

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16
Q

Aging & reproductive

How does man sex decline comapre to female menopause?

A

testosterone in man&raquo_space; slower and variable declinning comapre to rapid hormone drop in womens

17
Q

what hormonal changes aging mans exprerience?

A

decrease testosterone
higher LH
higher SHBG

18
Q

what sexual changes common in aging man

3

A
  1. reduce volume
  2. longer erectile latency
  3. more stimulation needed for erection
19
Q

which 2 symtoms indicate low testosterone level?

A
  1. reduce libido
  2. erectile failure
20
Q

aging &cardiovascular

How does aging affect afterload

A

increase afterload&raquo_space; increase SBP&raquo_space; higher PP (SBP- DBP)

21
Q

what happens to the aorta during aging? what is the consequence?

A

arotic root dilation+ elastin to collagen&raquo_space; stiffer aorta&raquo_space; increase afterload&raquo_space; increase SBP

22
Q

what are the two main changes in aging on the heart?

and how the heart compensate?

A
  1. increased afterload
  2. loss in cardiomyocyte number

compensation:
Concentric LVH&raquo_space; systolic S4 (physiological in elderly)&raquo_space; LA enlargment (backflow)

23
Q

How does elderly affect the adrenergic responsivness?

A

decrease adrenergic responsivness&raquo_space; reduce baroreceptors sensetivity > orthostasis Hyptotension

24
Q

what arethe changes in occur in the lung with aging?

A
  1. Increase dead space
  2. Ventilation perfusion mismatch

due to elastin degradation&raquo_space; muscle remodling&raquo_space; chest wall stiffness

25
Q

How aging affect lung complience?

A
  1. Decrease chest wall compliance
  2. increases lung compliance
26
Q

how aging affect TLV and RV

A

TLV- constant
RV- increases

27
Q

How aging alter force VC (vital capacity)

A

reduce FVC (due to increase RV)

28
Q

how aging affect on high altitude?

A

impair adaptation , due to decrease chaset and alveolar compliance

29
Q

how aging affect atrial PO2 and PCO2

A

O2- lower
CO2- no change

30
Q

which of the following paramters chenge during elderly?
* TLC
* FVC
* RV
* Lung complaince
* Total respiratoy sys. compliance
* Physiological dead space

A
  • TLC- unchange
  • FVC- decrease
  • RV- increase
  • Lung complaince- increase
  • Total respiratoy sys. compliance- decrease
  • Physiological dead space- increase
31
Q

Aging + orophyryngeal

all of the following can cause an increase risk of ____________

reduce saliva, receding gums, wekaer swalloing muscles, impair taste and smell

A

Dysphagia

32
Q

Why there is a reduce saliva in aging?

A

Amyloid deposition in acinar glends

33
Q

why are imapired reflexes significant in elderly dysphagia?

A
  1. increase risk for aspiration
  2. impare airway protection
34
Q

what the different in drug metabolisim between Neonates and Elderly?

A

neonates- higher body water content and low fat = large volume distribution for water soluble drugs

USMLE HY notes (24 decks)

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