Geriatrics

Question 1

Insomnia is associted w/ what characteristics?

Answer 1

Day time fatigue
Irritability
Problems concentrating

Question 2

What are the 4 common types of insomnia?

Answer 2

• Difficulty falling asleep
• Mid sleep awakening
• Early morning awakening
• Nonrestorative sleep

Question 3

Transient/acute insomnia?

Answer 3

<1wk

Question 4

Short term/subacute insomnia?

Answer 4

1wk-3mo

Question 5

Chronic insomnia?

Answer 5

> 3mo

Question 6

Is polysomnography indicated for regular eval of insomnia?

Answer 6

no

Question 7

How can insomnia be diagnosed?

Answer 7

• Sleep questionnaires
• Sleep log
• Interview bed partner

Question 8

Non-pharm therapy for insomnia

Answer 8

• sleep hygiene
• behavioral therapy
• Bright light therapy

Question 9

What class of drugs is Rx for insomnia?

Answer 9

Benzos

Question 10

Do you want to give benadryl for insomnia pt?

Answer 10

No

Question 11

Clinical presentation of Sleep apnea

Answer 11

• daytime sleepiness
• morning HA or lethargy/confusion
• bed partner reporting: loud snoring, apnea, choking, gasping sounds

Question 12

Dx sleep apnea?

Answer 12

Polysomnography

Lab –> Hypoxia, Hypercapnia

Question 13

What is the most important predictor of sleep apnea?

Answer 13

Obesity (increase BMI)

Question 14

Tx sleep apnea

Answer 14

• Weight loss
• Oral dental devices that reposition jaw/tongue
• CPAP

Question 15

What should sleep apnea pt avoid?

Answer 15

• alcohol
• sedatives
• sleeping supine

Question 16

What is perioidic limb movement disorder?

Answer 16

Recurring episodes of rhythmic movements during sleep

Question 17

What is restless leg syndrome?

Answer 17

Uncomfortable irresitable urge to move legs just before onset of sleep
-motor restlessness

Question 18

What are characterisitics of FTT?

Answer 18

• weight loss
• decreased appetite, poor nutrition
• inactivity
• accompanied by dehydration, depression, impaired immune function and low choelsterol

Question 19

What are some appetite stimulators that can be given to FTT pt?

Answer 19

• Megestrol (caution edema and DVT)

- Dronabinol (limit use 2/2 side effects)

Question 20

What Psychostimulant is used for geriatric depression and FTT?

Answer 20

Methylphenidate

Question 21

What visual acuity is considered blind?

Answer 21

<20/200

Question 22

Vision impairment is defined as….?

Answer 22

best corrected visual acuity worse than 20/40 and better than 20/200 in better seeing eye

Question 23

Si/Sx cataracts

Answer 23

• glare-related vision loss
• painless, progressive decline in vision
• difficult w/ contrast sensitivity
• color perception is off
• yellow discolroation to lens
• alteration in red reflex

Question 24

Tx cataracts

Answer 24

Surgery (indicated if 20/50 or worse)

• phacoemulsification
• clear corneal incision

Question 25

What is the leading cause of vision loss in >60yo

Answer 25

Age related macular degeneration

Question 26

Si/Sx macular degeneration?

Answer 26

- loss central vision (peripheral spared) - bilateral - impaired colored vision - scotomas - distortion straight lines

Question 27

Tx neovascular Age related macular degen?

Answer 27

Laser surgery | -focal photocoagulation or photogynamic therapy

Question 28

Define glaucoma

Answer 28

- elevated IOP - optic disc cupping - visual field loss

Question 29

RF Glaucoma

Answer 29

Black hispanic fam hx

Question 30

Primary open angle glaucoma si/sx

Answer 30

- blurred vision - halos around light - impaired dark adaptation - vision loss start at nasal field

Question 31

Closed angle glaucoma si/sx

Answer 31

- Blurred vision - HA - N/V - Corneal edema - Mid dilated pupil

Question 32

most common cause of hearing loss

Answer 32

Presbycusis (sensoneural hearing loss)

Question 33

most common cause hearing loss in middle/external ear?

Answer 33

Wax