Geriatric Health Maintenance Flashcards Preview

FAMILY MEDICINE > Geriatric Health Maintenance > Flashcards

Flashcards in Geriatric Health Maintenance Deck (30):
1

Typical presentation of presbyacusis

elderly person complains of difficulty understanding speech and conversation in noisy areas (loss of high frequency and speech discrimination)

age-related SENSORINEURAL hearing loss

2

Examples of IADL

cooking, driving, shopping, housecleaning, laundry, using the phone, money management

3

Examples of ADL

bathing, dressing, eating, continence, toilet, grooming

4

What kinds of conditions lead to vision loss in elderly

presbyopia, cataracts, glaucoma, macular degeneration, diabetic retinopathy

5

What is the leading cause of severe vision loss in elderly

age-related macular degeneration AMD

6

What happens to vision in presbyopia

difficulty focusing on nearby objects while distant vision remains intact

7

Pathophysiology of AMD

atrophy of cells in central macular region of retinal pigment epithelium resulting in loss of central vision

8

How to treat AMD

laser photocoagulation and intravitreal injections of vascular endothelial growth factor (VEGF)

9

Increased intraocular pressure leading to optic nerve neuropathy

glaucoma

10

risk factors for glaucoma

increased intraocular pressure, family history, vision changes, AA race...if have risk factors, do routine screening

11

Most common cause of blindness worldwide

cataracts...definitive treatment is surgery

12

Leading cause of blindness in working age adults in US

diabetic retinopathy

13

Common causes of geriatric hearing impairent

presbycusis, noise-induced hearing loss, cerumen impaction, otosclerosis, central auditory processing disorder

14

otosclerosis

autosomal dominant disorder of bones in the inner ear that results in progressive conductive hearing loss with onset late 20s-early 40s

15

central auditory processing disorder

conditions that reult from CNS dysfunction; can hear sounds fine just has difficulty understanding spoken language

16

Evidence for routine screening of vision and hearing in elderly

INSUFFICIENT

17

Leading cause of nonfatal injuries in elderly

falls

18

how to prevent falls

incorporation of exercise and physical therapy, as well as vitD supplementation

19

How to screen for dementia

MMSE; clock draw; three item recall

20

Easy screen for depression

have you felt down/depresed/hopeless in last two weeks? have you felt little interest or pleasure in doing things?

21

How to assess nutritional status in elderly

serial weight measurements and inquiry about changing appetite

22

What can protein undernutrition look like?

increased risk of infections, anemia, orthostatic hypotension, decubitis ulcers

23

2 greatest risk factors for stroke

1. HTN
2. afib

24

How to reduce risk of strokes in patients with afib

anticoagulation!

warfarin, dabigatran, apixaban

25

When to stop mammograms?

until life expectancy falls below 5 to 10 years; insufficient evidence for or against screening in women over 75

26

When to stop colon cancer screening

75-85

27

When to stop cervical cancer screening

65; only if you've had adequate prior screening and aren't at high risk for cervical cancer

28

What vaccines should someone over 65 get?

influenza annually, at least one pneumococcal and single booster Tdap

one dose of herpes zoster at 60 older

29

advance directive

oral/written statements made by patients when they are competent that are intended to guide care should they become incompetent

30

What proportion of patients who undergo CPR in the hospital actually survive to discharge?

15% :(