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Flashcards in Comprehensive Geriatric Assessment Deck (61):
1

What are the two parts of the CGA?

Multidisciplinary evaluation where multiple problems are considered...to develop a coordinated care plan

2

What is the purpose of the CGA? (3)

1. Prevent decline in performance of ADLs and IADLs
2. Screen for impairments
3. Screen for preventable disease

3

What are the three pros to the CGA?

Improves function
Improves QOL
Decreases hospitalization

4

What are the members of a geriatric assessment team?

CMA/RN
Social worker
PharmD
Dr.

5

What are the IADLs?

Telephone
Transportation
Meds
Finances

6

What are the five areas of the GSA?

1. Medical
2. Function
3. Psych
4. Social
5. Environment

7

What are the parts of the psychosocial assessment?

Cognitive assessment
Mood/depression testing

8

What are the five parts of the medical assessment?

Problem list
Comorbid conditions
Disease severity
Medication review
Nutritional status

9

What are the four parts of the functional assessment

ADLs
IADLs
Activity/exercise
Gait/balance

10

As pts lose the ability to do IADLs., then how likely are they to develop dementia?

1 = 1
2= 2.34
3 = 4.54

11

What percent of the elderly population have nutritional disorders?

20-30%

12

What are the lab tests used to check for nutritional status?

ALbumin
cholesterol

13

What is the get up and go test? What is considered a failure?

Pt has to get up from a seated position walk 10 ft, then return

Fail if more than 20 secs

14

True or false: the get up and go test is still valid for pts using an assistive device

False

15

What are the two parts of the psych assessment?

1. Look for atypical presentation of depression
2. Assess cognitive function

16

What are the risk factors for depression? (2)

h/o social isolation
recent losses

17

What are the tools to assess cognitive function?

1. Folstein mini-mental state exam
2. Montreal cognitive assessment
3. Clock draw
4. Verbal fluency
5. Mini-cog

18

What is the karnofsky scale?

Assessment for cognition

19

True or false: you should involve family members at a f/u meeting for cognitive deficit findings

True

20

What are the two goals of geriatric prevention?

Increase function (ADLs, IADLs)
Improve QOL

21

What is the secondary form of disease prevention?

Screening/detecting of asymptomatic

22

What is the tertiary form of disease prevention?

Treating complications

23

What is the primary form of disease prevention?

Immunization

24

What is the cost of missed prevention opportunities?

$55 billion

25

What is the cost of unnecessary services?

$210 billion

26

What are the top three causes of death in the elderly as of 2010?

CA
Heart disease
LRIs

27

What is the purpose of the USPSTF?

Determine whether or not evidence supports providing a clinical preventive service

28

What does the "C" rating by the USPSTF mean?

Clinicians may provide this service to selected pts

29

What does the "I" rating by the USPSTF mean?

Evidence that the service effectiveness is lacking, poor quality

30

What are the two A and B recommendations by the USPSTF?

Bone mass measurement
Colorectal CA screening
Mammograms
Pap/pelvic

31

What fraction of pts with breast CA are 65+?

More than half

32

What is the chance of developing breast CA at age 50? At 80?

1:50

1:8

33

What is the rating given by the USPSTF for breast biennial mammograms?

B

34

What is the rating given by the USPSTF for breast self exams?

D

35

What is the rating given by the USPSTF for breast biennial mammograms for women over the age of 75?

I

36

What is the rating given by the USPSTF for breast MRI screens for breast CA?

I

37

What is the age cutoff for biennial mammograms?

75 yo

38

What percent of cervical cancers are caused by HPV?

93%

39

True or false: older women are less likely to present with advanced cervical CA?

True

40

At what age are pap smears not recommended? What is the USPSTF recommendation?

65

D

41

Women aged 21-65 would get pap smears how often?

Every three years

42

What is the recommendation for cervical CA screening for women 30-65?

Combination of cytology and HPV testing

43

Why is COPD associated with osteoporosis?

Chronic steroid use may cause osteoporosis

44

What are the major risk factors for osteoporosis?

Wt >60 kg
EtOH
Smokes
Family h/o
Caffeine

45

What is the single best indicator of osteoporosis?

wt

46

What is the USPSTF recommended of screening for osteoporosis for men and women?

B for women 65+
I for men

47

What are the two risk factors for prostate CA?

First degree relative
African American

48

True or false: it is not known whether a PSA screen will reduce the risk of death from prostate CA

True

49

What are the two diseases that can show elevated PSA?

prostatitis or BPH

50

What is the USPSTF recommendation for PSA screening?

D

51

What fraction of men with limited life expectancy continue to receive PSA?

1/3

52

Does a 65 yo white male need a PSA test?

No

53

For every 3000 PSA tests, how many pts get ED or incontinence?

120

54

For every 3000 PSA tests, how many pts get CV event?

6

55

For every 3000 PSA tests, how many pts get a DVT?

3

56

For every 3000 PSA tests, how many pts die?

1

57

What percent of colon CAs happen after the age of 50?

90%

58

In what population is colon CA high?

African American men

59

Colon cancer has an A rating for what age range?

from 50 to 75

60

What is the absolute cutoff for colon CA screening?

85 yo

61

What are the three other recommendations for screening in pts? (3)

Cognitive impairment
Glaucoma screening
TSH in women