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Geriatric/Pediatric Flashcards

(71 cards)

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1
Q

Notable growth in ____ y/o population and shrinking in __ ___ y/o population

A
  • 65+
  • 14
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2
Q

Gerontology

A

Study of aging

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3
Q

Geriatrics

A

Subspecialty of clinical medicine focusing on caring for the aged

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4
Q

How does CRP change with age?

A

Increases

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5
Q

How does albumin change with age?

A

Decreases

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6
Q

How do muscle mass and total creatinine production change with age?

A
  • Both decrease
  • Rate and extent of muscle mass loss have strong genetic component
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7
Q

How does total bone density change with age?

A

Decreases
Much more dramatic for women post-menopause

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8
Q

How do serum calcitonin and PTH change with age (bone metabolism)?

A

Both increase

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9
Q

Which GIT issues increase with age?

A
  • Atrophic gastritis
  • Low gastric production
  • Increased malnutrition
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10
Q

Which vitamin/mineral/protein deficiencies worsen with age?

A
  • Vit B12 deficiency
  • Decreased calcium
  • Decreased iron absorption
  • Decreased albumin
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11
Q

How do the following change with aging?
Number of functional glomeruli
GFR/renal blood flow
Kidney concentrating ability
Acid/base, water, electrolyte levels

A

All decrease!!

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12
Q

Which urinary system hormones increase with age?

A

EPO, ANP (atrial natriuretic peptide), and BNP (b-type natriuretic peptide)

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13
Q

Which urinary system hormones decrease with age?

A

Renin and responsiveness to ANP

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14
Q

What happens to the thymus with age?

A

Shrinks

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15
Q

What immune substance increases with age?

A

ANAs (anti-nuclear antibodies)

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16
Q

What immune substances decrease with age?

A
  • Thymosin
  • T-cell and B-cell function
  • Hematopoietic stem cells
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17
Q

Which endocrine system hormones usually remain stable with age?

A
  • ACTH
  • Epinephrine
  • TSH (but may slightly increase)
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18
Q

Which endocrine system hormones usually increase with age?

A
  • Norepinephrine secretion
  • ANP
  • PTH
  • ADH/AVP
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19
Q

Which endocrine system hormones usually decrease with age?

A
  • GH
  • Peak melatonin
  • Aldosterone
  • DHEA
  • IGF-1
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20
Q

How does glucose metabolism change with age?

A
  • Insulin secretion does not change BUT insulin sensitivity decreases
  • People with genetic predisposition to Type 2 diabetes more likely to manifest illness (increasing age, BMI, lack of exercise)
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21
Q

What are some factors that impact interpretation of lab results for elderly population?

A
  • Exercise type/duration
  • Meds
  • Mobility
  • Nutritional status
  • Personal habits
  • Presence of chronic/subclinical disorders
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22
Q

What factor correlate with muscle mass and renal function?

A

Creatinine levels

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23
Q

Osteoporosis due to

A

lack of sex hormones and hypogonadism

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24
Q

Inadequate calcium absorption leads to ____________________________

A

low serum calcium and increased PTH, which then increases calcium loss from bones -> increases ALP

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25
Which GIT substances increase with age?
CRP, GGT, and fibrinogen
26
Which GIT substances decrease with age?
Ferritin, transferrin, albumin, and total protein
27
Enlargement of prostate leads to
Increase in prostate specific antigen (PSA), which can cause urinary obstruction
28
How doe sex hormones (testosterone, estrogen, and progesterone) change with age?
All decrease
29
How does increase in age affect drug absorption, distribution, metabolism, and elimination?
- Absorption=rate slows - Distribution=highly water-soluble drugs tend to be more concentrated due to decreased body water - Metabolism=hepatic blood flow/mass decrease - Elimination=renal blood flow/mass decrease -> decline in GFR
30
Which factor was emphasized to have a big impact on increased lifespan and quality of life in geriatrics?
Exercise
31
A baby delivered at term weighs about __
3.2 kg
32
A baby whose birth weight is below the ___ percentile for gestational age is considered **small**
10th
33
Organ development at birth
Most organs are **not fully** developed
34
GFR and renal tubular function at birth
Both mature during the first year of life
35
Normal intrauterine development time period
38-40 weeks of gestation
36
Infant phlebotomy complicated by which factors?
- Patient size - Inability for patient to communicate
37
Which type of testing plays an important/expanding role in pediatric practice?
Point-of-care testing (POCT) aka near-patient testing
38
POCT factors to be considered
- Turnaround time - Evaluation of POCT devices - Device limitations for pediatric use
39
Primary maintenance of blood gas and pH homeostasis following birth requires **what** to regulate acid-base metabolism?
Sufficiently mature lungs and kidneys
40
Which cells does the lung express at 24 wk of gestation and what are their functions?
- Type 1 pneumocytes = gas exchange - Type 2 pneumocytes = secrete surfactant containing lecithin and sphingomyelin
41
Why is surfactant important for the lungs?
Necessary for the lungs to expand and transfer blood gases after delivery
42
Respiratory Distress Syndrome (RDS)
Failure to excrete CO2 and the levels rise -> causing **respiratory acidosis**
43
Blood gas measurement in neonates
- Non-invasive transcutaneous devices measure oxygen and CO2 status - Some analyzers take small capillary samples in pediatric settings
44
Anaerobic collection from neonates
Must be free-flowing from heelstick and sealed/processed fast
45
What other analytes can blood gas analyzers measure for neonates?
- Lactate - Urea - Bilirubin - Creatinine
46
Advantages and disadvantages of blood gas analyzer measuring lactate, urea, bilirubin, and creatinine?
- Advantage = smaller blood volume needed - Disadvantage = can't tell if sample is hemolyzed
47
Disorders that cause hypernatremia and hyponatremia must be treated in neonates to prevent ___
Seizures
48
Cause of physiologic jaundice in neonates
Failure of immature liver to properly metabolize bilirubin
49
Which organ plays an essential role in energy metabolism for the whole body?
Liver
50
Blood glucose homeostasis/hepatic metabolism of glucose are maintained by which hormones?
- Glucagon - Cortisol - Epinephrine - IGF
51
Type 1 diabetes previously called ___
juvenile
52
Type 2 diabetes cases ____
have grown tremendously in the last 30 years
53
Which organ plays a central role in nitrogen metabolism?
Liver
54
Liver synthesizes which proteins?
- albumin - transferrin - complement clotting factors
55
Liver metabolism of breakdown products turn into ___
- ammonia - urea - creatinine - uric acid
56
Blood ammonia levels are typically higher in which age group compared to which other age group?
Higher in newborns than older kids
57
Which is a potential new test, not routinely used yet, for testing renal function in neonates?
Cystatin C
58
Creatinine and uric acid levels in newborns
Lower
59
Lack of Vit D can cause
Rickets
60
Normal bone growth requires integration of which elements?
- calcium - phosphate - magnesium
61
Normal bone growth requires endocrine regulation from which hormones?
- Vit D - PTH - Calcitonin
62
Hypothalamus secretes which hormone in the thyroid system?
TRH
63
Adrenal cortex system regulates
Mineral and carb metabolism
64
Hypothalamus secretes which two regulatory hormones that affect growth?
- GH-inhibiting factor (somatostatin) - GHRH
65
Hypothalamus secretes which sexual maturation hormone?
GnRH (suppressed in infants and young children)
66
Human fetus synthesizes which Ab?
Small amount of IgM and IgA to lesser extent
67
How does prematurity affect infant immunity?
Transient hypogammaglobinemia
68
Severe combined immune deficiency (SCID)
Lack both humoral and cellular immunity (boy in bubble)
69
Common genetic disease within Caucasian population in the US
Cystic fibrosis
70
Newborn screening tests
- PKU - Steroid 21-hydroxylase deficiency - Sickle cell disease - CF - Galactosemia (some states/countries)
71
Theophylline is metabolized to ___ in neonates but not adults
Theophylline

Clinical Chemistry (21 decks)

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