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Flashcards in geriatrics Deck (14)
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Top 6 causes of mortality in Canada/USA

1. Heart disease and CVD
2. Malignant neoplasms
3. Cerebrovascular disease
4. Chronic lower respiratory disease
5. Accidents
6. Alzheimer's Disease


Diagnosis of Alzheimer's

1. anterograde amnesia (inability to learn new info)
2. any one of the following:
- apraxia (loss of ability to perform learned movements despite intact motor fxn)
- agnosia (failure to identify objects)
- disturbance in executive function
- mood alterations


earliest and most severely affected areas of brain in alzheimer's

hippocampus and temporal lobe


microscopic pathology in alzheimer's

- senile plaques (beta-amyloid proteins)
- neurofibrillary tangles


3 major genes fo autosomal dominant Alzheimer's disease

1. amyloid precursor protein (APP) gene at chromosome 21 (esp people with Down's syndrome)
2. presenilin-1 at chrom 14 (early onset)
3. presenilin-2 at chrom 1 (early onset)


testing/imaging for Alzheimer's

- presumptive diagnosis made w/ mental status testing (orientation, verbal recall, language, visual-spatial)
- EEG (generalized slowing, nonspecific)
- MRI: dilation of lateral ventricles, widening of cortical sulci
- Single photon electron computed tomography (SPECT): hypometabolism in temporal and parietal lobes


Tx (drugs) for Alzheimer's: AChE Inhibitors

Donezepil (mild to moderate AD)
- C/I include risk of ulcers/GI bleed, COPD, ulcers, asthma, CAD, CHF, bradycardia, arrythmia


pathophysiology of Osteoarthritis

articular cartilage deteriorates d/t reduction of proteoglycan, then body can't repair cartilage faster than rate of deterioration --> osteophytes (bone spurs) are made


joint stiffness in osteoarthritis

- localized, gradually progressive, intermittent flare ups
- joint stiffness after inactivity
-- waking in am, after sitting, worse with activity


Which hand joints are enlarged in OA

- DIPs (Heberden's nodes)
- PIPs (Bouchard's nodes)
- Carpometacarpal joint of thumb
--MCPs are usually not affected


4 hallmark radiologic findings in OA

1. Joint space narrowing (usu asymetrical)
2. subchondral sclerosis
3. subchondral cysts
4. osteophytes


Imaging for transient ischemic attacks

Noncontrast cranial CT


labs to run if suspect malnutrition

CBC, electrolytes, Ca, Mg, PO4, Cr, liver function tests (including albumin, INR, bilirubin), B12, folate, TSH, transferrin, lipid profile, and urinalysis


Tx for urinary incontinence

Tolterodine - urinary antispasmodic; anticholinergic
- interacts with drugs inhibiting CYP-2D6 (fluoxetine, amiodarone, cimetidine)