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Physical Assesment 2023 > Examination Of The Geriatric Patient > Flashcards

Examination Of The Geriatric Patient Flashcards

(56 cards)

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1
Q

Who lives longer men or women?

A

Women life expectancy = 84
Men = 81

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2
Q

What to focus on when having an older adult as a patient

A

They are very goal oriented
*focus on patients individual health goals

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3
Q

What is the sixth vital sign

A

Functional assessment

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4
Q

What are the geriatric syndromes?

A
  1. Cognitive impairments
  2. Falls
  3. Urinary incontinence
  4. Frailty
  5. Low BMI
  6. Dizziness
  7. Impaired vision and hearing
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5
Q

What do elderly patients do about symptoms that they may be experiencing

A

Under report them
*accidentally or intentionally
*overestimate health
*afraid, embarrassed, avoid clinical expenses
*over look their symptoms

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6
Q

What is the definition of geriatric syndromes and what are they linked to?

A
  1. A multi factorial condition that involves the interaction between identifiable situation-specific stressor and underlying age-related risk factors, resulting in damage across multiple organ systems
    *linked to functional decline
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7
Q

What are the shared risk factors of the elderly?

A
  1. Increased age
  2. Cognitive impairment
  3. Functional impairment
  4. Impaired mobility
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8
Q

What are the different types of ADLs

A
  1. Washing
  2. Dressing
  3. Feeding
  4. Toileting
  5. Walking
  6. Transferring
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9
Q

What are IADLs

A

Instrumental activities of daily living
1. Shopping
2. Cooking/cleaning
3. Using telephone or transportation
4. Managing money and medications
*SCUM

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10
Q

What is the single most common modifiable risk factor associated with falls?

A
  1. Medications
    *ask the patient to bring in all medication bottles and OTC
    *keep the number of drugs to a minimum
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11
Q

If an elderly patient does not report their pain what can that lead to?

A
  1. Persistent pain
    *make sure to ask at every visit
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12
Q

What advice to give for smoking an alcohol consumption

A

Smoking
*advise to quit at every visit
Alcohol
*no more than 2 drinks on any one day or 7 drinks a week
*CAGE

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13
Q

How often should you weight elderly patients?

A
  1. All the time
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14
Q

When should Advanced directed and palliative care be discussed ?

A
  1. Before onset of serious illness
    *provide information, clarify the patients preferences, identify surrogate decision maker
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15
Q

What is palliative care

A
  1. Alleviation of pain, suffering
  2. Promotion of optimal QOL
  3. Considering the physical, mental, spiritual, and social well-being of patients while ensuring patient dignity and respecting autonomy
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16
Q

What do falls cause to the elderly

A
  1. Significant morbidity and mortality in older patients
    *60% of injuries due to falls
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17
Q

At what age should breast cancer be screened

A

Start 50
End 74

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18
Q

When should colorectal cancer be screened

A

Start 60
End 70

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19
Q

When should lung cancer be screened for?

A

50 to 80
*20 pack year history, current smoker, or quit within the 15 years
*annual screen with LDCT

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20
Q

What is the USPSTF screening for vision and hearing?

A

I
*but recommend for geriatricians
*ask patients about hearing loss (use whisper test)

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21
Q

What can exercise do for the elderly

A
  1. Decrease in all cause mortality
  2. Recommend aerobic with muscle strengthening
  3. 150 minutes MI or 75 VI minutes per week
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22
Q

What are the recommendation for immunizations

A
  1. Influenza
  2. Td or Tdap (10 years)
  3. Pneumococcal vaccines
  4. Zoster (>50)
  5. COVID
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23
Q

How to screen for depression

Study These Flashcards
A
  1. Geriatric depression scale
  2. USPSTF = B
  3. Often under diagnosed, untreated or under treated
24
Q

What is dementia

Study These Flashcards
A
  1. Acquired condition that is characterized by a decline in at least two cognitive domains that is severe enough to affect social or occupational functioning
    *loss of memory
    *attention
    *language
25
What is the most predominant cognitive impairment disorder
1. Alzheimer’s disease
26
How to screen for cognitive impairment
1. Mini mental state examination *24-30 = no cognitive impairment *18-23 = mild cognitive impairment *0-17 = serve cognitive impairment
27
What are changes that happen to the BP and HR
BP *systolic HTN *postural hypotension HR *resting HR remains unchanged *decline in pacemaker cells and max HR *common to have arrhythmias
28
What are changes that happen to the respiratory rate and temperature
RR *unchanged Temp *unchanged
29
What are changes that happen to the O2 saturation, height, weight
O2 *>90% Height and weight *kyphosis, muscle mass loss
30
What does functional evaluation (sixth vital sign) provide a baseline for>
1. Provides a baseline for making interventions that optimize the patients level of function and for identifying geriatric syndromes *cognitive impairment *falls *incontinence
31
what does DIAPERS stand for?
D: Delirium I: infection A: atrophic urethritis / vaginitis P: pharmaceuticals E: excess urine output R: restricted mobility S: stool impaction
32
What does DDRRIIPP stand for?
D: delirium D: drug SE R: retention of feces R: restricted mobility I: infection of urine I: inflammation P: Polyuria P: psychogenic
33
What is actinic purpura
Capillaries are leaky *rupture of delicate blood vessel walls *leads to erythematous purpura
34
What is actinic keratoses
*flatten yellow papule *rough scaly patch on the skin
35
What is actinic lentigines
Liver spots *due to sun exposure
36
what is seborrheic keratoses
1. Raised yellow/brown greasy looking spots
37
What is ectropion, entropion and arcus senilis
Ectropion *eyelid folds out Entropion *eyelid folds in Arcus senilis *phospholipid deposition, benign, high cholesterol
38
What are the eye changes that happen to the elderly
1. Smaller pupils 2. Visual acuity diminishes rapidly >70 *presbyopia
39
What are cataracts
Thickening and yellowing of the lens, impairs passage of light *world leading cause of blindness
40
What is open angle glaucoma
Intraocular pressure is elevated due to reduced drainage of aqueous fluid through the trabecular mesh work *will be sudden loss of vision emergency
41
What is macular degeneration
1. Poor central vision and blindness *dry atrophic (MC) and wet exudative or neovascular *Drusen = colloid bodies causing alteration in pigmentation
42
What is presbycusis
Hearing loss with aging
43
What is angular cheilitis
1. Over-closure at the angle of the mouth *can happen when removing the dentures
44
What happen to the neck vessels with the elderly
Will be lengthening and tortuosity of aorta *kink or buckling of the carotid artery *pulsatile mass (may be mistaken for a carotid aneurysm)
45
How does systolic bruits happen>
1. Stenosis from atherosclerotic plaque
46
What type of extra heart sounds will be heard
1. Pathology third heart sound (S3) *CHF, volume overload 2. Fourth heart sound (S4) *decreased ventricular compliance
47
What happens to the cardiac output in the elderly
1. Less responsive to stimulation from B adrenergic catecholamines
48
What is a systolic aortic murmur (cardiac murmur)
1. Fibrotic changes thicken the bases of the aortic cusps, calcification occurs, turbulence in flow creates even more sound 2. Aortic sclerosis *fibrosis and calcification = no blood flow obstruction 3. Aortic stenosis *aortic valve leaflets become pacified and immobile
49
What is mitral regurgitation (cardiac murmur)
1. Calcification of mitral valve annuls or valve ring, impedes closure during systole *may be pathology as volume overload increases in LV
50
What should you do if there is a loss of arterial pulses?
1. Evaluate carefully
51
What is the glandular tissue of the breast replaced with while aging
Fat *will be flaccid and pendulous *ducts more easily palpable
52
What are some causes of erectile dysfunction
1. Atherosclerotic occlusive disease 2. Corpora cavernosa venous leak 3. Chronic disease 3. Smoking
53
What is the cause of loss of cortical and trabecular bone mass
1. Calcium reabsorption from bone rather than diet
54
How to screen bone mineral density
DEXA
55
What is a benign essential tremor?
1. Bilateral *worse when the patient is trying to use the limb
56
What are the sings of Parkinson’s disease ?
TRAP Tremor, rigidity, akinesia, postural instability *bradykinesia, micrographia, shuffling gait, difficulty rising from a chair

Physical Assesment 2023 (20 decks)

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