Geriatric Assessment and Health Maintenance Flashcards

Question

What are the beers criteria?

Answer 1

Medications generally considered inappropriate when given to elderly people. Medications listed tend to cause side effects in the elderly due to the physiologic changes of aging.

Answer 2

``` Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) Mobility, Strength and Vision: --Gait --Balance --Strength --Vision ```

Answer 3

``` bathing dressing transferring walking eating grooming ```

Answer 4

if they are independent, require assistance, or are dependent

Answer 5

``` use of the phone transportation shopping meal preparation shopping meal preparation house work medical management management of finances ```

Answer 6

71-74 years 1% >90 years 17% NH patients 17%

Answer 7

71-74 years 7% >90 years 39% NH patients 19%

Answer 8

annual eye examination | screening test

Answer 9

65-74 years = 24% | >75 years = 40%

Answer 10

audioscope | whisper test

Answer 11

A handheld otoscope with a built-in audiometer

Answer 12

Purposeful movement from one place to another independently.

Answer 13

Balance Muscle strength Gait speed

Answer 14

(in meters or feet per second) - Slow gait speed predicts several adverse events including falls, disability, hospitalization and decreased survival.

Answer 15

Tandem walk | Berg Balance Scale – may take longer time.

Answer 16

Developed to measure balance among older people with impairment in balance function by assessing the performance of functional tasks. It is a valid instrument used for evaluation of the effectiveness of interventions and for quantitative descriptions of function in clinical practice and research.

Answer 17

1. Observe is the patient is able to stand up from a sitting position without the support of his/her arms. 2a. If they are not able to stand up, STOP. 2b. If they are able to stand up: ask the patient to: 3a. Sit in a chair with back straight and arms over the chest. 3b. Stand up from sitting position as many times as possible in 30 seconds.

Answer 18

lower extremity muscle strength

Answer 19

``` Can be done during a clinic visit: Ask patient to stand up from a sitting position Walk 10 ft (3 meters) Turn around and walk back to the chair And sit back in the chair ```

Answer 20

Simple test to evaluate lower extremity strength, balance and walking speed.

Answer 21

Seconds Rating: | 29 seconds: Impaired mobility

Answer 22

screening tests

Answer 23

Alzheimer’s disease and vascular dementias comprise >80% of cases

Answer 24

Risk for functional decline, delirium, falls and caregiver stress

Answer 25

Consists of: 1. 3-items delayed recall – assesses memory. 2. Clock drawing test (CDT) - assesses executive function (ability to plan, make decisions, prioritize, trouble shoot, etc).

Answer 26

``` Recall = 0 -> abnormal Recall = 1-2 clock test = abnormal -> abnormal Recall = 1-2 Clock test = normal -> normal Recall = 3 -> normal ```

Answer 27

mini-mental state test

Answer 28

Not suitable for making a diagnosis but can be used to indicate the presence of cognitive impairment (such as suspected dementia or following a head injury)

Answer 29

Fast and More sensitive in detecting cognitive impairment than the use of informal questioning or overall impression of a patient's orientation

Answer 30

Provides measures of orientation, registration (immediate memory), short-term memory (but not long-term memory) as well as language functioning.

Answer 31

Assesses five different cognitive (mental) functional abilities: Orientation to time and place Registration – the ability to repeat named prompts. Attention Span and Arithmetic (count or spell backwards) Memory and recall- going back to the named objects in the registration section. Language- asked to repeat a phrase points are awarded of 5 pts for each correct answer

Answer 32

28 >85 y/o and >12yrs education 29 70-74 y/o and >12yrs education 22 65-69 y/o and 0-4 yrs education

Answer 33

pts education level

Answer 34

``` Scores: 25-30 out of 30 are considered normal 21-24 is considered mild 10-20 as moderate <10 as severe impairment. ```

Answer 35

The MMSE may not be an appropriate assessment if the patient has learning, linguistic/communication or other disabilities (e.g. sensory impairments).

Answer 36

Associated with physical decline of community-dwelling adults and hospitalized patients

Answer 37

the geriatric depression scale

Answer 38

``` History of unintentional weight loss Current body mass index Number of meals per day Accessibility of food items Problem with chewing and swallowing ```

Answer 39

10 pounds in one year | 5 pounds in 6 months

Answer 40

Urinary and fecal

Answer 41

``` Ask: How often do you have problem with leakage of stool? Never Less than once a month 2 -3 times per month At least once a week Daily ```

Answer 42

Slowed reaction time Impaired protective responses Comorbid Diseases

Answer 43

Second leading cause of brain and spinal cord injury in older adults.

Answer 44

Death Broken bones 20% of restricted activity days (more than any other condition) Nursing Home Placement

Answer 45

Pneumonia Dehydration Rhabdo

Answer 46

Handrails on both sides of any stairway Well lit stairways and walkways No-slip backing on rugs Hand bars in bath/shower

Answer 47

Tend to take longer to fall asleep. Lower sleep efficiency More night time awakenings Wake up earlier

Answer 48

``` Circadian Rhythm Changes Sleep Apnea Medical Illness Multiple Medications Psychiatric Illness Dementia Poor Sleep Hygiene ```

Answer 49

Collection of symptoms, signs or findings that are commonly found among older adults and predict adverse outcomes which include: Disability Institutionalization Increased mortality.

Answer 50

slow walking speed, decreased muscle strength, decreased energy expenditure (physical activity), unintentional weight loss, fatigue.

Answer 51

transportation Financial Factors Economic factors may impact nutritional status, medication availability, etc.

Answer 52

``` Physical Abuse Neglect Financial or Material Abuse Psychological Verbal ```

Answer 53

1. The condition must have a significant effect on health. 2. Acceptable methods of preventive intervention must be available for the condition. 3. The intervention must be effective in preserving health for primary prevention (counseling, chemoprevention, immunizations). 4. For other preventive services or interventions: - ---Must be period before patient is aware of the condition (seriousness or implications) during which it can be detected. - ---Tests must be available. - ---Preventive services/treatment must have greater effectiveness than after condition is delayed. 5. The benefits of preventive service or treatment must outweigh any negative effects. 6. A comparison of the cost and benefits must be conducted.

Answer 54

US Preventive Services Task Force – no age limit. | Benefit may emerge 18-24 months after treatment is started.

Answer 55

Favorable if life expectancy is >10 years | US Preventive Services Task Force does not recommend screening for those >=75 years old.

Answer 56

US Preventive Services Task Force recommend screening for women up to age 74 years. Favorable if life expectancy is >5 years

Answer 57

Colonoscopy; favorable if life expectancy is >7-10 years.

Answer 58

Low Risk; Immunize

Answer 59

Low Risk; Immunize annually.

Answer 60

Reduce herpes zoster incidence by 53% and post herpetic neuralgia by 65%.

Answer 61

qT boostter q 10 yrs

Answer 62

``` HTN Smoking Inactivity Hypercholesterolemia (screening questionable/not cost effective) Obesity DM ```

Answer 63

Responsible for up to 30% of MIs and CVAs. | Stopping smoking reduces CV mortality within 1 year.

Answer 64

Regular exercise should be recommended Associated with reduced CV mortality Positive CV effects include reduced BP, lipids, obesity and DM

Answer 65

Postmenopausal estrogen associated with CAD and a 50% reduction in risk of death in women.

Answer 66

ASA (81 mg) on a daily basis is recommended (in absence of contraindications) for stroke and CV risk reduction.

Answer 67

Reduced fat intake (with exception of olive oil, fatty fish, many types of nuts) appears to have protective effects.

Answer 68

Avoiding excess EtOH consumption may prevent HTN (moderate amounts appear to reduce events).

Answer 69

Incidence increases with age (more aggressive forms in younger).

Answer 70

Treatment with Lumpectomy and Tamoxifen well tolerated & effective.

Answer 71

Comparatively rare in the elderly. Patients with a history of normal PAP smears do not PAP screening beyond 65 BUT those without previous screening should have 2 normal PAPs before discontinuing.

Answer 72

Risk of CC increases with age. | DREs and FOBTs alone are not effective as screens.

Answer 73

Regular use of ASA associated with reduced cancer risk.

Answer 74

recommended against screening in those >75

Answer 75

common in older men and often asymptomatic.

Answer 76

recommended against in those >75

Answer 77

Tobacco and EtOH increase risk.

Answer 78

Oral cancer treatment at an early stage improves outcomes.

Answer 79

No, except in the lungs. still screen if they have a history of smoking.

Geriatric Assessment and Health Maintenance Flashcards

(117 cards)