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Geriatrics > Changes & Common Conditions > Flashcards

Changes & Common Conditions Flashcards

1
Q

Integumentary System normal age-related changes

A

Decreased: H2O, sweat glands, elasticity.
Collagen stiffens.
Thinner basement membrane, epidermis, subQ.
Dermis atrophy & fragility.
Disorganized small vessels.

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2
Q

Genitourinary System normal age-related changes

A

Kidney: dec waste filtering, slower blood filtering as vessels harden.
Pelvic floor: musc weaken.
Bladder: inc contractions (urge), dec voided volume (less goes out, more left behind), dec bladder capacity.
Prostate enlarges & squeezes urethra (restricts emptying).

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3
Q

Immune System normal age-related changes

A

Inc systemic inflammation.
Decreased: B & T cell production, lymphocyte function, WBC count.
Macrophages slow.
Poor response to vax.

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4
Q

MSK System normal age-related changes

A

Decreased: lean musc mass (sarcopenia), size/# of type 1 & 2 fibers, # motor units, flexibility, ROM, vertebral height, bone density.
Increased: IMAT, cocontraction of agonist & antagonist (stiffness).

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5
Q

Cardiopulm System normal age-related changes

A

Decreased: vital capacity, VO2max, HRmax, # pacemaker cells.
Increased: vessel stiffness.

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6
Q

Neuro System (5 senses) normal age-related changes

A

Vision: decreased acuity, depth perception, rods/cones, & pupil size.
Smell: decreased odor perception, olfactory cells.
Taste: decreased taste buds, saliva.
Touch: degeneration of pacinian & meissners, decreased peripheral sensation & hot/cold discrimination.
Hearing: hair cell dysfunction (vestib), tympanic membrane sclerosis (hearing).

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7
Q

Neurological normal age-related changes

A

Decreased brain size/weight.
Decreased blood flow to brain.
Neuron atrophy (in brain & spinal cord).
Slow N conduction (reduced sensation, reflexes, rxn time).
Vestibular: decreased hair cells, less effective VOR, increased otoliths.

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8
Q

Pain normal age-related changes

A

Reduced pain sensitivity for lower pain intensities (esp heat and pain affecting head).
Less light touch sesnsation d/t thin skin.

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9
Q

Gait normal age-related changes

A

Decreased: speed, stride/step length.
Increased: DL stance time, variability in gait pattern.

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10
Q

When is Shingles contagious?

A

If open wound, liquid coming out.
ONLY contagious to those who are not vax or never had virus (no antibodies).
Not contagious once it crusts over.

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11
Q

What is Xerosis?

A

excessive drying of the skin.
Becomes itchy, burning, feels tight.
Can crack/open –> infections.

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12
Q

What is Cellulitis?

A

rapidly spreading infection (dermis & SubQ).
Common when skin is already broken & edema present.
VERY red skin - not just a little redness, “angry red”

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13
Q

Why are skin conditions common in DM?

A

Ulcers, neuropathy.
Slower wound healing ability, slower metab function (plus additional slowing as a result of age).

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14
Q

Urinary Incontinence types: Stress

A

Occurs when some sort of stressor to the pelvic floor (sneezing, lifting, Valsalva, etc.)

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15
Q

Urinary Incontinence types: Urge

A

Bladder muscle contracts more frequently - more freq need to go.
Often triggered by an event (e.g. walking in the door).

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16
Q

Urinary Incontinence types: Mixed

A

Stress + urge

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17
Q

Urinary Incontinence types: Double

A

Fecal + urinary

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18
Q

Urinary Incontinence types: Functional

A

Physical limitation prevents getting to the bathroom (walker can’t fit thru door, can’t get pants unbuttoned in time, etc)

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19
Q

What is urinary retention?

A

> 100cc left behind after going
Risk of UTI

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20
Q

Constipation: often a result of _____ and often leads to ____

A

Medication side effect.
Stress incontinence (straining or full bowel pushes on bladder).

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21
Q

Prolapse affects what?

A

Bladder morphology

22
Q

What is Benign Prostate Hyperplasia?

A

Enlarged prostate.
Affects bladder morphology.

23
Q

Sexual dysfunction usually caused by what?

A

Decreased hormone production.

24
Q

How does RA differ from OA?

A

Morning stiffness, bilateral.
Longer duration, more pain at rest.
Usually the smaller joints (fingers, toes, etc).
Systemic changes - fatigue, weight loss, fever, anemia.

25
Q

Avoid what intervention with RA? Why?

A

Mobs/manips of upper c-spine.
Transverse ligament weakens & facets erode.

26
Q

Common cancers in older adults

A

Leukemia
Hormonal (breast, prostate)
Digestive

27
Q

Common sign of cancer

A

Fatigue disproportional to activity

28
Q

After age 50, muscle MASS declines at a rate of ____

A

1-2% per yr

29
Q

After age 50, muscle STRENGTH declines at a rate of ____

A

4% per yr

30
Q

What is IMAT?

A

Increased adipose between & within muscles.
Decreased strength and power (limited contractilitiy).
Strength training will NOT help bc force production won’t improve as long as fat still there (need to lose fat instead).

31
Q

Which muscle fibers decrease faster?

A

Type 2 (force production, power)

32
Q

Which declines first: muscle mass or strength?

A

Strength

33
Q

Bone density decreases at a rate of ____ after menopause (age 50 for men)

A

1-2% per yr

34
Q

Kyphosis can result in…

A

Anterior wedging compression fx (can cause kyphosis or be caused by kyphosis).
Poor ventilation - hard to inflate when hunched over.
GI issues bc stuff is squished.

35
Q

Osteopenia/porosis T-scores

A

0 to -1 = NORMAL
-1 to -2.4 = osteopenia
-2.5 or lower = osteoporosis
-2.5 or lower plus fx = severe osteoporosis

36
Q

Why are hip fractures REALLY bad in older adults?

A

Often non-union, takes way longer to heal than joint replacement.
Nutrition issues, infections, complications of ORIF, adverse response to anesthesia/meds, pneumonia, DVTs

37
Q

What is the most important cardiopulm consideration?

A

Decreased HRmax - determines extent of exercise intensity.
Can still do 80% HRmax

38
Q

HTN meds considerations

A

Dose determined based on resting BP, not exercise BP. Activity may overwhelm meds.

39
Q

Increased blood vessel stiffness results in…

A

Increased BP
Decreased LV contractility
Decreased CO
Slow O2 perfusion to tissues = muscle burn lasts longer, requires longer rest/recovery

40
Q

Pneumonia

A

Most common infectious cause of death.
Often misdiagnosed or caught late.
Symptoms may present more as confusion, lethargy.

41
Q

Dysrhythmia best detected by…

A

Palpating pulse (not pulse ox!)

42
Q

Decreased rods/cones affects…

A

Night vision
Color discrimination
Peripheral/upper fields

43
Q

Normal DTRs in older adults

A

Usually 1+ instead of 2+
Due to slower N conduction (normal age related change)

44
Q

Common vision conditions

A

Presbyopia (inability to see near, need reading glasses)
Cataracts, glaucoma, macular degen

45
Q

Risk of CVA >55yo

A

Doubles every decade

46
Q

Most appropriate way to test for sensation

A

Sharp/dull discrimination (bc light touch decreased)

47
Q

Chronic pain types: nociceptive

A

activation of pain receptors

48
Q

Chronic pain types: neuropathic

A

pathology of central and/or peripheral nervous system

49
Q

Chronic pain types: mixed/unspecified

A

multiple sources of pain, often longer duration

50
Q

What is Cachexia?

A

excessive metabolic wasting, does not respond to exercise

51
Q

What is the leading cause of disability in older adults (that is NOT a normal age-related change)?

A

Chronic pain

Geriatrics (7 decks)

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